Alemtuzumab Disease Interactions

Severe, including fatal, autoimmune anemia and thrombocytopenia, and prolonged myelosuppression have been reported in patients receiving alemtuzumab. It is recommended to withhold therapy for severe cytopenias and to discontinue therapy for autoimmune cytopenias or recurrent/persistent severe cytopenias (except lymphopenia). It is recommended to monitor complete blood counts (CBC) at weekly intervals during therapy and more frequently if worsening anemia, neutropenia, or thrombocytopenia occurs and to assess CD4+ counts after treatment until recovery to >= 200 cells/µL.

The use of alemtuzumab can cause severe infusion reactions, including pyrexia, chills/rigors, nausea, hypotension, urticaria, dyspnea, rash, emesis, and bronchospasm. Caution should be taken in patients with a history of pulmonary disease, heart disease as they may require dose-escalation and additional pre-infusion medications to manage complications as appropriate.

Alemtuzumab should be used with caution in patients at risk of opportunistic infections, as therapy could result in severe and prolonged lymphopenia. It is recommended to administer prophylaxis against Pneumocystis jiroveci pneumonia (PCP) and herpes viral during and for a minimum of 2 months after completion of therapy or until the CD4+ count is >=200 cells/µL. Routinely monitor patients for CMV infection during therapy and withhold therapy for serious infections and during antiviral treatment for CMV infection or confirmed CMV viremia.