Alemtuzumab binds to CD52, a nonmodulating antigen that is present on the surface of essentially all B- and T- lymphocytes, a majority of monocytes, macrophages, and NK cells, and a subpopulation of granulocytes. The proposed mechanism of action is antibody-dependent lysis of leukemic cells following cell surface binding. The maximum serum concentration and the AUC has shown relative dose proportionality.



Alemtuzumab has been associated with infusion-related events including hypotension, rigors, fever, shortness of breath, bronchospasm, chills, or rash. In order to ameliorate or avoid infusion-related events, premedicate patients with an oral antihistamine and acetaminophen prior to dosing and monitor closely.

In addition, initiate alemtuzumab at a low dose with gradual escalation to the effective dose. Careful monitoring of blood pressure and hypotensive symptoms is recommended, especially in patients with ischemic heart disease and in patients on antihypertensive medications. If therapy is interrupted for at least 7 days, reinstitute alemtuzumab with gradual dose escalation.

How to Take Alemtuzumab

Take Alemtuzumab exactly as prescribed by health care provider. Alemtuzumab is generally available in market in the form of Powder for injection, lyophilized 7.5 mg, Avoid shaking the ampule before use. Discard ampule if solution has been frozen.Dilute in 100 mL 0.9% Sodium Chloride or 5% Dextrose. Mix the solution by gently inverting the bag. Diluted solutions are preservative-free and should be used within 24 hr to reduce the risk of microbial contamination. The manufacturer recommends use within 8 hr.

Indications for Alemtuzumab Drug

Refractory B-cell chronic lymphocytic leukemia. If the patient experiences a reaction, the infusion may be continued at the same rate at the health care provider's discretion. Temporarily interrupt the infusion or decrease the rate for severe reactions, including hypotension, hypertension, shortness of breath, or rash. Symptoms may be treated with hydrocortisone (eg, Solu-Cortef ) 200 mg IV, diphenhydramine (eg, Benadryl ), acetaminophen (eg, Tylenol ), bronchodilators, oxygen, or IV fluids. Monitor the patient until symptoms resolve completely. Patients who react to alemtuzumab infusions may receive additional doses. Hydrocortisone or an equivalent corticosteroid may be added to the pretreatment regimen at the practitioner's discretion.

Contraindications for Alemtuzumab Drug

Patients who are allergic to alemtuzumab, in patients with active systemic infections, and in patients with underlying immunodeficiency.

What are the Side Effects of Alemtuzumab -

Like other medicines, Alemtuzumab can cause side effects. Some of the more common side effects of Alemtuzumab include

* Hypotension; peripheral edema; hypertension; supraventricular tachycardia.

* Fatigue; headache; dysesthesias; asthenia; dizziness; insomnia.

* Rash; urticaria; pruritus; increased sweating.

* Moderate to low potential for nausea and vomiting; diarrhea; anorexia; mucositis;, abdominal pain; and dyspepsia common.

* Myelosuppression (80% to 85%); fatal pancytopenia; marrow hypoplasia; autoimmune anemia; autoimmune thrombocytopenia.

* Dyspnea; cough; bronchitis or pneumonitis; pneumonia; pharyngitis.

* Rigors and fever in more than 80% of patients during the infusion or within 45 to 60 minutes afterward. Nausea; vomiting; rash; urticaria; dyspnea; hypotension; and chills also may occur.

* Skeletal pain; myalgias; back pain; chest pain.

Warnings and precautions before taking Alemtuzumab :

* Serious, potentially fatal (rare) pancytopenia, marrow hypoplasia, autoimmune idiopathic thrombocytopenia, and autoimmune hemolytic anemia have occurred before using Alemtuzumab.

* Serious sometimes fatal opportunistic infections (bacterial, viral, fungal, and protozoan) reported.

* Advise women before using Alemtuzumab to inform health care provider if pregnant, planning to become pregnant, or breastfeeding while taking Alemtuzumab. Insulin is recommended to maintain blood glucose levels during pregnancy. Prolonged severe neonatal hypoglycemia can occur if sulfonylureas are administered at time of delivery.

* Women of childbearing age and men of reproductive before using Alemtuzumab potential should use effective contraceptive methods during treatment and for at least 6 mo after alemtuzumab therapy.

* Avoid immunization with live attenuated vaccines during this period, including BCG, measles, mumps, rubella, Ty21a typhoid, varicella, yellow fever, and others.

What if Overdose of Alemtuzumab ?

If you think you or anyone else taken overdose of Alemtuzumab , immediately telephone your doctor or contact your local or regional Poisons Information Centre Seek medical attention immediately. You may need urgent medical attention. Chills, headache, arthralgia, sinusitis are may be the overdose symptoms of Alemtuzumab.

What if Missed Dose of Alemtuzumab ?

If you miss a dose of Alemtuzumab medicine and you remember within an hour or so, take the dose immediately. If you do not remember until later, skip the dose you missed and go back to your regular schedule. Do not double doses.

Storage Conditions for Alemtuzumab :

Refrigerate; do not freeze. Protect from direct sunlight. Store diluted solutions of Alemtuzumabat room temperature or in the refrigerator. Protect from light. Diluted solutions of Alemtuzumabat are preservative-free and should be used within 24 hr to reduce the risk of microbial contamination. The manufacturer recommends use within 8 hr.

By: ashu