Infections after the use of alemtuzumab in solid organ transplant recipients: a comparative study.
We undertook a retrospective cohort study comparing infection in solid organ transplant recipients receiving alemtuzumab (n = 726) versus basiliximab (n = 215) or antithymocyte globulin (ATG) (n = 85). Eighty-one percent of patients had kidney transplants. Overall, 33% of patients in the alemtuzumab group (240/724) developed infection compared with 40% (87/215) in the basiliximab group (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.53-0.99; P = .04). The frequency of infection was similar in the alemtuzumab and ATG groups (33% versus 36%, respectively, P = .53). The frequency of fungal infections, most caused by Candida spp., was similar in the alemtuzumab and basiliximab groups (10% versus 9%); disseminated fungal infection occurred in 68% of the patients with fungal infection receiving alemtuzumab and in 30% of the patients with fungal infection receiving basiliximab (OR, 4.76; 95% CI, 1.58-14.28; P = .003). Basiliximab posed a higher risk than alemtuzumab for infection. Disseminated candidal infections were more common in patients receiving alemtuzumab.
Safdar
Nasia
N
Department of Medicine, Section Infectious Diseases, University of Wisconsin, Madison, WI 54792, USA. ns2@medicine.wisc.edu
Smith
Jeannina
J
Knasinski
Valerie
V
Sherkow
Colleen
C
Herrforth
Casey
C
Knechtle
Stuart
S
Andes
David
D
D000328:Adult; D000368:Aged; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000008:administration & dosage / Q000009:adverse effects*; D000961:Antilymphocyte Serum / Q000009:adverse effects / Q000627:therapeutic use; D000077552:Basiliximab; D015331:Cohort Studies; D000077561:Daclizumab; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host / Q000187:drug effects; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology / Q000382:microbiology; D009894:Opportunistic Infections / Q000209:etiology* / Q000382:microbiology / Q000821:virology; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000961:Antilymphocyte Serum; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000074323:Alemtuzumab; D000077552:Basiliximab; D000077561:Daclizumab