Long-Term Infectious and Noninfectious Outcomes of Monthly Alemtuzumab as a Calcineurin Inhibitor- and Steroid-Free Regimen for Pancreas Transplant Recipients
Joint Authors
Kaplan, Adam
Young, Jo-Anne H.
Kandaswamy, Raja
Berglund, Danielle
Knoll, Bettina M.
Sieger, Gretchen
Cavert, Winston
Matas, Arthur
Obeid, Karam M.
Source
Canadian Journal of Infectious Diseases and Medical Microbiology
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-12, 12 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-10-10
Country of Publication
Egypt
No. of Pages
12
Main Subjects
Abstract EN
Multiple doses of alemtuzumab for immunosuppressive therapy of patients with hematologic malignancies and hematopoietic stem cell transplant have been associated with a high rate of infection.
In transplantation, limited alemtuzumab dosing has been successfully used as induction immunosuppression.
The effect of multiple doses of alemtuzumab, used as maintenance therapy to minimize steroid and/or calcineurin inhibitor toxicity in solid organ transplant recipients, is unknown.
We evaluated the infectious and noninfectious outcomes of 179 pancreas transplant recipients treated with alemtuzumab for induction and maintenance therapy (extended alemtuzumab exposure (EAE)) from 2/28/2003 through 8/31/2005, compared with 159 pancreas transplant recipients with standard induction and maintenance (SIM) therapy performed before (1/1/2002 until 12/31/2002) and after (1/1/2006 until 12/31/2006) the implementation of EAE.
EAE was associated with higher risk of overall infections (hazard ratio (HR) 1.33 (1.06–1.66), P=0.01), bacterial infections (HR 1.33 (1.05–1.67), P=0.02), fungal infections (HR 1.86 (1.28–2.71), P<0.01), and cytomegalovirus infections (HR 2.29 (1.39–3.77), P<0.01).
In addition, EAE was associated with higher risk of acute cellular rejection (HR 2.09 (1.46–2.99), P<0.01).
In conclusion, while a limited alemtuzumab dosing is safe and effective for induction therapy in pancreas transplantation, EAE combined with steroid and calcineurin minimization is associated with a high risk of infectious complications and acute cellular rejection.
American Psychological Association (APA)
Kaplan, Adam& Young, Jo-Anne H.& Kandaswamy, Raja& Berglund, Danielle& Knoll, Bettina M.& Sieger, Gretchen…[et al.]. 2020. Long-Term Infectious and Noninfectious Outcomes of Monthly Alemtuzumab as a Calcineurin Inhibitor- and Steroid-Free Regimen for Pancreas Transplant Recipients. Canadian Journal of Infectious Diseases and Medical Microbiology،Vol. 2020, no. 2020, pp.1-12.
https://search.emarefa.net/detail/BIM-1139203
Modern Language Association (MLA)
Kaplan, Adam…[et al.]. Long-Term Infectious and Noninfectious Outcomes of Monthly Alemtuzumab as a Calcineurin Inhibitor- and Steroid-Free Regimen for Pancreas Transplant Recipients. Canadian Journal of Infectious Diseases and Medical Microbiology No. 2020 (2020), pp.1-12.
https://search.emarefa.net/detail/BIM-1139203
American Medical Association (AMA)
Kaplan, Adam& Young, Jo-Anne H.& Kandaswamy, Raja& Berglund, Danielle& Knoll, Bettina M.& Sieger, Gretchen…[et al.]. Long-Term Infectious and Noninfectious Outcomes of Monthly Alemtuzumab as a Calcineurin Inhibitor- and Steroid-Free Regimen for Pancreas Transplant Recipients. Canadian Journal of Infectious Diseases and Medical Microbiology. 2020. Vol. 2020, no. 2020, pp.1-12.
https://search.emarefa.net/detail/BIM-1139203
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1139203