Alemtuzumab levels impact acute GVHD, mixed chimerism, and lymphocyte recovery following alemtuzumab, fludarabine, and melphalan RIC HCT

Alemtuzumab levels impact acute GVHD, mixed chimerism, and lymphocyte recovery following alemtuzumab, fludarabine, and melphalan RIC HCT

Marsh RA, 2016, Blood (Link to abstract)       

Hematopoietic stem cell transplantation (HSCT) data from 105 patients who underwent conditioning with a reduced intensity (RIC) protocol using alemtuzumab, fludarabine, and melphalan was collected. Alemtuzumab levels were measured peri HSCT. The authors found a correlation of lower alemtuzumab levels with higher incidence of: acute GVHD, full donor chimerism, faster lymphocyte recovery by day +30. The authors concluded that an optimal alemtuzumab level on day 0 would be in the therapeutic range of 0.2 to 0.4 μleve.


* This report correlates alemtuzumab levels to acute GVHD, donor chimerism, and lymphocyte recovery and suggests to perform targeted drug monitoring trials to test their hypothesis of optimal alemtuzumab levels in RIC HSCT.