Infections after the use of alemtuzumab in solid organ transplant recipients: a comparative study

Diagn Microbiol Infect Dis. 2010 Jan;66(1):7-15. doi: 10.1016/j.diagmicrobio.2009.08.017.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Alemtuzumab
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm / administration & dosage
  • Antibodies, Neoplasm / adverse effects*
  • Antilymphocyte Serum / adverse effects
  • Antilymphocyte Serum / therapeutic use
  • Basiliximab
  • Cohort Studies
  • Daclizumab
  • Female
  • Graft Rejection / drug therapy
  • Humans
  • Immunocompromised Host / drug effects
  • Immunoglobulin G / administration & dosage
  • Immunoglobulin G / adverse effects
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Mycoses / etiology
  • Mycoses / microbiology
  • Opportunistic Infections / etiology*
  • Opportunistic Infections / microbiology
  • Opportunistic Infections / virology
  • Recombinant Fusion Proteins / administration & dosage
  • Recombinant Fusion Proteins / adverse effects
  • Retrospective Studies

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm
  • Antilymphocyte Serum
  • Immunoglobulin G
  • Immunosuppressive Agents
  • Recombinant Fusion Proteins
  • Alemtuzumab
  • Basiliximab
  • Daclizumab