Typhlitis as a complication of alemtuzumab therapy.
Alemtuzumab is a humanized monoclonal antibody directed against lymphocytes through the CD-52 receptor, an antigen being found on > 95% of peripheral blood lymphocytes and monocytes, and to a smaller extent on granulocytes. It is an effective immunotherapeutic agent in patients with malignancies such as non-Hodgkin lymphoma, B cell chronic lymphocytic leukemia and T cell pro- lymphocytic leukemia. Adverse side effects are increasingly recognized in patients receiving alemtuzumab, mainly including fever, rigors, nausea/vomiting, skin rash; other severe alemtuzumab-related reactions have also been described, such as lymphopenia and neutropenia leading to both opportunistic (e.g. cytomegalovirus) and non-opportunistic infections. Digestive complications have more rarely been described, i.e.: gastroenteritis and peritonitis. We recently observed a case of particular interest as the patient with T cell prolymphocytic leukaemia treated with alemtuzumab, exhibited symptomatic reactivation of CMV infection and developed subsequently typhlitis.
Marie
I
I
Department of Internal Medicine, Rouen University Hospital, France. isabelle.marie@chu-rouen.fr
Robaday
S
S
Kerleau
J M
JM
Jardin
F
F
Levesque
H
H
D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015463:Leukemia, Prolymphocytic / Q000276:immunology / Q000628:therapy; D015458:Leukemia, T-Cell / Q000276:immunology / Q000628:therapy; D008875:Middle Aged; D053706:Typhlitis / Q000175:diagnosis* / Q000209:etiology* / Q000276:immunology
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000970:Antineoplastic Agents; D000074323:Alemtuzumab