Skip to main content
Journal cover image

Alemtuzumab in the treatment of refractory acute rejection and bronchiolitis obliterans syndrome after human lung transplantation.

Publication ,  Journal Article
Reams, BD; Musselwhite, LW; Zaas, DW; Steele, MP; Garantziotis, S; Eu, PC; Snyder, LD; Curl, J; Lin, SS; Davis, RD; Palmer, SM
Published in: Am J Transplant
December 2007

Despite substantial improvements in early survival after lung transplantation, refractory acute rejection (RAR) and bronchiolitis obliterans syndrome (BOS) remain major contributors to transplant-related morbidity and mortality. We have utilized alemtuzumab, a humanized anti-CD52 antibody which results in potent lymphocyte depletion, in consecutive patients with RAR (n = 12) or BOS (n = 10). All patients failed conventional treatment with methylprednisolone and antithymocyte globulin and received strict infection prophylaxis. Alemtuzumab significantly improved histological rejection scores in RAR. Total rejection grade/biopsy was 1.98 +/- 0.25 preceding alemtuzumab versus 0.33 +/- 0.14 posttreatment, p-value <0.0001 (with a similar number of biopsies/patient per respective time interval). Freedom from BOS was observed in 65% of RAR patients 2 years after alemtuzumab treatment. Although there was no statistically significant change in forced expiratory volume in 1 second (FEV1) before and after alemtuzumab treatment in patients with BOS, a stabilization or improvement in BOS grade occurred in 70% of patients. Patient survival 2 years after alemtuzumab for BOS was 69%. Despite a dramatic decline in CD4 counts in alemtuzumab-treated patients, only one patient developed a lethal infection. Thus, we provide the first evidence that alemtuzumab is a potentially useful therapy in lung transplant recipients with RAR or BOS.

Duke Scholars

Published In

Am J Transplant

DOI

ISSN

1600-6135

Publication Date

December 2007

Volume

7

Issue

12

Start / End Page

2802 / 2808

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Analysis
  • Surgery
  • Middle Aged
  • Male
  • Lung Transplantation
  • Lung
  • Kaplan-Meier Estimate
  • Humans
  • Graft Rejection
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Reams, B. D., Musselwhite, L. W., Zaas, D. W., Steele, M. P., Garantziotis, S., Eu, P. C., … Palmer, S. M. (2007). Alemtuzumab in the treatment of refractory acute rejection and bronchiolitis obliterans syndrome after human lung transplantation. Am J Transplant, 7(12), 2802–2808. https://doi.org/10.1111/j.1600-6143.2007.02000.x
Reams, B. D., L. W. Musselwhite, D. W. Zaas, M. P. Steele, S. Garantziotis, P. C. Eu, L. D. Snyder, et al. “Alemtuzumab in the treatment of refractory acute rejection and bronchiolitis obliterans syndrome after human lung transplantation.Am J Transplant 7, no. 12 (December 2007): 2802–8. https://doi.org/10.1111/j.1600-6143.2007.02000.x.
Reams BD, Musselwhite LW, Zaas DW, Steele MP, Garantziotis S, Eu PC, et al. Alemtuzumab in the treatment of refractory acute rejection and bronchiolitis obliterans syndrome after human lung transplantation. Am J Transplant. 2007 Dec;7(12):2802–8.
Reams, B. D., et al. “Alemtuzumab in the treatment of refractory acute rejection and bronchiolitis obliterans syndrome after human lung transplantation.Am J Transplant, vol. 7, no. 12, Dec. 2007, pp. 2802–08. Pubmed, doi:10.1111/j.1600-6143.2007.02000.x.
Reams BD, Musselwhite LW, Zaas DW, Steele MP, Garantziotis S, Eu PC, Snyder LD, Curl J, Lin SS, Davis RD, Palmer SM. Alemtuzumab in the treatment of refractory acute rejection and bronchiolitis obliterans syndrome after human lung transplantation. Am J Transplant. 2007 Dec;7(12):2802–2808.
Journal cover image

Published In

Am J Transplant

DOI

ISSN

1600-6135

Publication Date

December 2007

Volume

7

Issue

12

Start / End Page

2802 / 2808

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Analysis
  • Surgery
  • Middle Aged
  • Male
  • Lung Transplantation
  • Lung
  • Kaplan-Meier Estimate
  • Humans
  • Graft Rejection