Low serum albumin level is associated with cytomegalovirus reactivation in patients with chronic lymphoproliferative diseases treated with alemtuzumab (Campath-1H)-based therapies.
BACKGROUND
Alemtuzumab (Campath-1H), a monoclonal antibody that targets the CD52 antigen, has been approved for the treatment of fludarabine-refractory chronic lymphocytic leukemia. However, the profound immunosuppression caused by alemtuzumab has been associated with infectious complications.


METHODS
The authors report on the incidence and risk factors for development of symptomatic cytomegalovirus reactivation in 113 patients with chronic lymphoproliferative disorders who received alemtuzumab-based therapy. Kaplan-Meier methods were applied to generate survival curves, and the log-rank test was used to assess the difference between groups; in addition, univariate and multivariate Cox proportional hazards models were used to estimate the hazard ratio of death including 95% confidence intervals.


RESULTS
Cytomegalovirus reactivation was diagnosed in 25 patients (22%), and most of those patients responded to antiviral therapy. Nine additional patients had asymptomatic cytomegalovirus viremia.


CONCLUSIONS
With appropriate therapy, most patients achieved clearance of cytomegalovirus viremia. Low serum albumin was the only factor associated significantly with symptomatic cytomegalovirus reactivation.
Borthakur
Gautam
G
Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Lin
E
E
Faderl
Stefan
S
Ferrajoli
Alessandra
A
Wierda
William
W
Giles
Francis
F
Browning
Mary L
ML
Kantarjian
Hagop
H
Keating
Michael
M
O'Brien
Susan
S
D000328:Adult; D000368:Aged; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000009:adverse effects*; D000956:Antigens, Viral / Q000032:analysis; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002908:Chronic Disease; D003587:Cytomegalovirus / Q000254:growth & development*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008232:Lymphoproliferative Disorders / Q000188:drug therapy* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D015996:Survival Rate; D016896:Treatment Outcome; D014775:Virus Activation
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000956:Antigens, Viral; D000970:Antineoplastic Agents; D012709:Serum Albumin; D000074323:Alemtuzumab