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Alemtuzumab as a Therapy for Chronic Lung Allograft Dysfunction in Lung Transplant Recipients With Short Telomeres.
Front Immunol. 2020; 11:1063.FI

Abstract

Alemtuzumab, a monoclonal antibody targeting CD52 that causes lymphocyte apoptosis, is a form of advanced immunosuppression that is currently used as a therapy for refractory acute cellular rejection and chronic lung allograft dysfunction in lung transplant recipients (1-3). Side effects of alemtuzumab include bone marrow suppression, infection, and malignancy. Whether alemtuzumab can be safely used in allograft recipients that have an increased propensity for bone marrow suppression due to telomeropathies is unknown. In a retrospective case series, we report outcomes associated with alemtuzumab in three lung allograft recipients with short telomere lengths, comparing endpoints such as leukopenia, transfusion needs, infection, hospitalization and survival to those of 17 patients without known telomeropathies that received alemtuzumab. We show that the use of alemtuzumab in lung transplant recipients with short telomeres is safe, though is associated with an increased incidence of neutropenia, thrombocytopenia and anemia requiring packed red blood cell transfusions. Alemtuzumab appears to be an acceptable advanced immunosuppressive therapy in patients with telomeropathies, though given the design and scope of this study, the actual clinical effect needs further evaluation in larger trials.

Authors+Show Affiliations

Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, United States. Harvard Medical School, Boston, MA, United States. Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, United States. Harvard Medical School, Boston, MA, United States.Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, United States.Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, United States.Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, United States.Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, United States. Harvard Medical School, Boston, MA, United States.Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, United States. Harvard Medical School, Boston, MA, United States.Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, United States. Harvard Medical School, Boston, MA, United States.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32547557

Citation

Trindade, Anil J., et al. "Alemtuzumab as a Therapy for Chronic Lung Allograft Dysfunction in Lung Transplant Recipients With Short Telomeres." Frontiers in Immunology, vol. 11, 2020, p. 1063.
Trindade AJ, Thaniyavarn T, Townsend K, et al. Alemtuzumab as a Therapy for Chronic Lung Allograft Dysfunction in Lung Transplant Recipients With Short Telomeres. Front Immunol. 2020;11:1063.
Trindade, A. J., Thaniyavarn, T., Townsend, K., Klasek, R., Tsveybel, K. P., Kennedy, J. C., Goldberg, H. J., & El-Chemaly, S. (2020). Alemtuzumab as a Therapy for Chronic Lung Allograft Dysfunction in Lung Transplant Recipients With Short Telomeres. Frontiers in Immunology, 11, 1063. https://doi.org/10.3389/fimmu.2020.01063
Trindade AJ, et al. Alemtuzumab as a Therapy for Chronic Lung Allograft Dysfunction in Lung Transplant Recipients With Short Telomeres. Front Immunol. 2020;11:1063. PubMed PMID: 32547557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alemtuzumab as a Therapy for Chronic Lung Allograft Dysfunction in Lung Transplant Recipients With Short Telomeres. AU - Trindade,Anil J, AU - Thaniyavarn,Tany, AU - Townsend,Keri, AU - Klasek,Robin, AU - Tsveybel,Karen P, AU - Kennedy,John C, AU - Goldberg,Hilary J, AU - El-Chemaly,Souheil, Y1 - 2020/05/28/ PY - 2019/12/16/received PY - 2020/05/04/accepted PY - 2020/6/18/entrez PY - 2020/6/18/pubmed PY - 2020/6/18/medline KW - alemtuzumab KW - augmented immunosuppression KW - chronic lung allograft dysfunction KW - chronic rejection KW - lung transplantation KW - short telomeres KW - telomere length SP - 1063 EP - 1063 JF - Frontiers in immunology JO - Front Immunol VL - 11 N2 - Alemtuzumab, a monoclonal antibody targeting CD52 that causes lymphocyte apoptosis, is a form of advanced immunosuppression that is currently used as a therapy for refractory acute cellular rejection and chronic lung allograft dysfunction in lung transplant recipients (1-3). Side effects of alemtuzumab include bone marrow suppression, infection, and malignancy. Whether alemtuzumab can be safely used in allograft recipients that have an increased propensity for bone marrow suppression due to telomeropathies is unknown. In a retrospective case series, we report outcomes associated with alemtuzumab in three lung allograft recipients with short telomere lengths, comparing endpoints such as leukopenia, transfusion needs, infection, hospitalization and survival to those of 17 patients without known telomeropathies that received alemtuzumab. We show that the use of alemtuzumab in lung transplant recipients with short telomeres is safe, though is associated with an increased incidence of neutropenia, thrombocytopenia and anemia requiring packed red blood cell transfusions. Alemtuzumab appears to be an acceptable advanced immunosuppressive therapy in patients with telomeropathies, though given the design and scope of this study, the actual clinical effect needs further evaluation in larger trials. SN - 1664-3224 UR - https://www.unboundmedicine.com/medline/citation/32547557/Alemtuzumab_as_a_Therapy_for_Chronic_Lung_Allograft_Dysfunction_in_Lung_Transplant_Recipients_With_Short_Telomeres L2 - https://doi.org/10.3389/fimmu.2020.01063 DB - PRIME DP - Unbound Medicine ER -
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