Alemtuzumab is a humanized monoclonal antibody directed at CD52 approved as a disease-modifying therapy for relapsing forms of multiple sclerosis (MS).
Objective:
To describe a case of a life-threatening autoimmune anemia occurring after a first course of alemtuzumab for relapsing-remitting MS in a 28-year-old male.
Methods:
Case report.
Results:
A 28-year-old male developed a life-threatening autoimmune anemia occurring 11 months after first alemtuzumab course.
Conclusion:
We report the third case of autoimmune hemolytic anemia following treatment with alemtuzumab in a young MS patient. Due to the severity of this adverse event, neurologists using this treatment should be alert.
WeinblattMEMaddisonPJBulpittKJet al. CAMPATH-1H, a humanized monoclonal antibody, in refractory rheumatoid arthritis. An intravenous dose-escalation study. Arthritis Rheum1995; 38: 1589–1594.
2.
CheungWWHwangGYTseEet al. Alemtuzumab induced complete remission of autoimmune hemolytic anemia refractory to corticosteroids, splenectomy and rituximab. Haematologica2006; 91(Suppl. 5): ECR13.
3.
CohenJAColesAJArnoldDLet al. Alemtuzumab versus interferon beta 1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: A randomised controlled phase 3 trial. Lancet2012; 380: 1819–1828.
4.
ColesAJTwymanCLArnoldDLet al. Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: A randomised controlled phase 3 trial. Lancet2012; 380: 1829–1839.
5.
WillisMDRobertsonNP.Alemtuzumab for multiple sclerosis. Curr Neurol Neurosci Rep2016; 16: 84.
6.
ElimelakhMDaytonVParkKSet al. Red cell aplasia and autoimmune hemolytic anemia following immunosuppression with alemtuzumab, mycophenolate, and daclizumab in pancreas transplant recipients. Haematologica2007; 92: 1029–1036.
7.
CukerAColesAJSullivanHet al. A distinctive form of immune thrombocytopenia in a phase 2 study of alemtuzumab for the treatment of relapsing-remitting multiple sclerosis. Blood2011; 118: 6299–6305.
8.
KellyWNArellanoFMBarnesJet al. Guidelines for submitting adverse event reports for publication. Pharmacoepidemiol Drug Saf2007; 16: 581–587.
9.
AzzopardiLThompsonSAJHardingKEet al. Predicting autoimmunity after alemtuzumab treatment of multiple sclerosis. J Neurol Neurosurg Psychiatry2014; 85: 795–798.
