Drug Interactions between alemtuzumab and YF-Vax

CONTRAINDICATED: The administration of live, attenuated virus or bacterial vaccines during alemtuzumab therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. Alemtuzumab binds to a cell surface antigen present at high levels on T and B lymphocytes (CD52), which results in antibody-dependent cellular cytolysis and complement-mediated lysis. Treatment generally depletes circulating T and B lymphocytes, resulting in immunosuppression. Patients receiving alemtuzumab may also have increased adverse reactions and decreased or suboptimal immunologic responses to vaccines.

MANAGEMENT: In general, live attenuated viral or bacterial vaccines should not be used in patients receiving immunosuppressive therapy or cancer chemotherapy, such as alemtuzumab. Product labeling for the alemtuzumab formulation used to treat multiple sclerosis recommends completing any necessary live immunizations at least 6 weeks prior to initiating treatment with alemtuzumab. After therapy is completed, some authorities suggest waiting until the patient's B- and T-cell levels have recovered to within the normal range, while other authorities recommend waiting at least 12 months after alemtuzumab to initiate vaccination with a live vaccine. As recommendations may be affected by the indication of alemtuzumab, the product labeling and any relevant local immunization guidelines should be consulted for the most up to date information.