Background: Alemtuzumab (Campath-1H), a monoclonal antibody that targets the CD52 antigen, has been approved for the treatment of fludarabine-refractory chronic lymphocytic leukemia. However, the profound immunosuppression caused by alemtuzumab has been associated with infectious complications.
Methods: The authors report on the incidence and risk factors for development of symptomatic cytomegalovirus reactivation in 113 patients with chronic lymphoproliferative disorders who received alemtuzumab-based therapy. Kaplan-Meier methods were applied to generate survival curves, and the log-rank test was used to assess the difference between groups; in addition, univariate and multivariate Cox proportional hazards models were used to estimate the hazard ratio of death including 95% confidence intervals.
Results: Cytomegalovirus reactivation was diagnosed in 25 patients (22%), and most of those patients responded to antiviral therapy. Nine additional patients had asymptomatic cytomegalovirus viremia.
Conclusions: With appropriate therapy, most patients achieved clearance of cytomegalovirus viremia. Low serum albumin was the only factor associated significantly with symptomatic cytomegalovirus reactivation.
Copyright (c) 2007 American Cancer Society.