title: Cancer-free survival following alemtuzumab induction in heart transplantation.
abstract: BACKGROUND
  The malignancy rate after alemtuzumab (C-1H) induction in cardiac transplantation is unknown.
  
  
  METHODS
  A retrospective analysis from a single center for all patients that underwent cardiac transplantation from January 2000 to January 2011 and that had no history of malignancy before transplantation was performed. Patients induced with alemtuzumab were compared with a group of patients receiving thymoglobulin or no induction and assessed for 4-year cancer-free post-heart transplantation survival.
  
  
  RESULTS
  Of 402 patients included, 185 (46.0%) received alemtuzumab, 56 (13.9%) thymoglobulin, and 161 (40.0%) no induction. Baseline characteristics did not differ between groups: mean age 54.0 years, male 77.1%, white 88.6%, ischemic cardiomyopathy 49.0%. The calcineurin inhibitor was tacrolimus in 98.9% of alemtuzumab patients, 98.2% of thymoglobulin patients, and 87.0% of the noninduced (P < .001). The secondary agent was mycophenolate mofetil in all but 16 noninduced patients (9.9%), who received azathioprine. The 4-year cancer-free survival did not differ between groups: 88.1% alemtuzumab, 87.5% thymoglobulin, 88.2% noninduction; P = .088. The 4-year nonskin cancer-free survival was 96.8% for the alemtuzumab group, 96.4% for the thymoglobulin group, and 95.7% for the noninduced; P = .899.
  
  
  CONCLUSIONS
  Neither the 4-year cancer-free survival nor the 4-year nonskin cancer-free survival differed between the alemtuzumab, thymoglobulin, and noninduced groups.
authors.affiliation: School of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: S
authors.initials: S
authors.lastname: Chivukula
authors.affiliation: Department of Pharmacy and Therapeutics, Pittsburgh, Pennsylvania.
authors.forename: M A
authors.initials: MA
authors.lastname: Shullo
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: R L
authors.initials: RL
authors.lastname: Kormos
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: C A
authors.initials: CA
authors.lastname: Bermudez
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: D M
authors.initials: DM
authors.lastname: McNamara
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address: teuteberggjj@upmc.edu.
authors.forename: J J
authors.initials: JJ
authors.lastname: Teuteberg
mesh_terms: D000328:Adult; D000368:Aged; D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000074323:Alemtuzumab