title: Use of alemtuzumab (Campath-1H) as induction therapy in pediatric kidney transplantation.
abstract: Alemtuzumab (Campath-1H) is a monoclonal antibody directed against CD52-positive B and T lymphocytes. Initial results of its use as an induction agent in adult renal transplantation have been encouraging. We report a case series of four low-risk pediatric renal transplantation patients who received 20 to 40 mg of alemtuzumab as induction followed by a steroid-free regimen consisting of a calcineurin inhibitor and mycophenolate mofetil. No infusion-related reactions occurred. Patients were aged 9 to 14 years with a mean creatinine of 1.2 mg/dL (range = 0.5-2.3 mg/dL) at a mean follow-up of 10 months (range = 4-16 months). One patient experienced biopsy-proven acute cellular rejections at 4 and 12 months posttransplantation, which were steroid sensitive. Lymphopenia post-alemtuzumab induction started to improve at 3 months posttransplantation. Two patients who received 40 mg of alemtuzumab experienced repeated infections that responded to 7-day courses of antibiotics. There was no cytomegalovirus disease detected. From these preliminary results, alemtuzumab seems to show a promising role to achieve adequate graft function with a steroid-free regimen among low-risk pediatric patients.
authors.affiliation: Department of Vascular Surgery, National Kidney and Transplant Institute, Quezon City, Philippines.
authors.forename: E T
authors.initials: ET
authors.lastname: Ona
authors.forename: R A
authors.initials: RA
authors.lastname: Danguilan
authors.forename: J
authors.initials: J
authors.lastname: Africa
authors.forename: C B
authors.initials: CB
authors.lastname: Cabanayan-Casasola
authors.forename: Z L
authors.initials: ZL
authors.lastname: Antonio
authors.forename: M A
authors.initials: MA
authors.lastname: Gutierrez-Marbella
authors.forename: R
authors.initials: R
authors.lastname: dela Cruz
authors.forename: N
authors.initials: N
authors.lastname: Bumanglag
authors.forename: M E
authors.initials: ME
authors.lastname: Espedilla
mesh_terms: D000293:Adolescent; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000469:parasitology; D006650:Histocompatibility Testing; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D009503:Neutropenia / Q000139:chemically induced
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000074323:Alemtuzumab; D003404:Creatinine