Document Detail

Alemtuzumab for cytolytic induction of immunosuppression in heart transplant recipients.
MedLine Citation:
PMID:  23187050     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To review available evidence about the safety and efficacy of alemtuzumab for induction of immunosuppression in heart transplant recipients.
DATA SOURCES: Searches of MEDLINE, EMBASE, and Cochrane databases were conducted. Key search terms included alemtuzumab, Campath-1H, CD52, lymphocyte, cytolytic, induction, immunosuppression, rejection, and cardiac transplantation. Additional pertinent data were identified through a search of abstracts from major transplant meetings.
STUDY SELECTION AND DATA EXTRACTION: All English-language articles and abstracts identified from the data sources were evaluated. All primary data were eligible for inclusion if they evaluated the safety or efficacy of alemtuzumab for induction of immunosuppression in heart transplant patients. One retrospective cohort, 1 case series, 1 case-control series, and 1 open-label trial were identified and included for review.
DATA SYNTHESIS: Acute cellular rejection occurs in 40% to 70% of heart transplant recipients within the first 6 months after transplant and is associated with significant morbidity and mortality. Depleting and nondepleting antibodies have displayed positive outcomes in inducing immunosuppression; however, the ideal induction strategy that balances efficacy and toxicity remains elusive. Alemtuzumab, a cytolytic anti-CD52 antibody, has been used to induce immunosuppression in kidney, pancreas, liver, intestine, and lung transplant recipients, and its use in heart transplant has been investigated. Studies of use of alemtuzumab to induce immunosuppression in heart transplant patients have shown low rates of rejection; however, it has not been directly compared with other immunosuppression-inducing agents and safety data are limited.
CONCLUSIONS: Although alemtuzumab may be a practical option for inducing immunosuppression, data are insufficient to recommend its routine use in deference to more established agents. Large, randomized clinical trials with extended durations of follow-up must be conducted to characterize its efficacy and safety further.
William D Cahoon; Christopher R Ensor; Michael A Shullo
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Progress in transplantation (Aliso Viejo, Calif.)     Volume:  22     ISSN:  1526-9248     ISO Abbreviation:  Prog Transplant     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-28     Completed Date:  2013-02-12     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  100909380     Medline TA:  Prog Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  344-9; quiz 350     Citation Subset:  N    
Virginia Commonwealth University Health System, Richmond, VA, USA.
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MeSH Terms
Antibodies, Monoclonal, Humanized / therapeutic use*
Graft Rejection / drug therapy,  immunology
Graft Survival / immunology
Heart Transplantation / immunology*
Immunosuppressive Agents / therapeutic use*
Reg. No./Substance:
0/Antibodies, Monoclonal, Humanized; 0/Immunosuppressive Agents; 3A189DH42V/alemtuzumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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