Outcomes with alemtuzumab induction therapy in lung transplantation: a comprehensive large-scale single-center analysis

Alberto Benazzo, Sophia Auner, Panja M Boehm, Annika Morscher, Stefan Schwarz, Bogdan Vidmar, Fedja Dzubur, Thomas Schweiger, Ali M Hoda, Bernhard Moser, Jose R Matilla, Gabriella Muraközy, Georg Lang, Shahrokh Taghavi, Walter Klepetko, Konrad Hoetzenecker, Peter Jaksch, Alberto Benazzo, Sophia Auner, Panja M Boehm, Annika Morscher, Stefan Schwarz, Bogdan Vidmar, Fedja Dzubur, Thomas Schweiger, Ali M Hoda, Bernhard Moser, Jose R Matilla, Gabriella Muraközy, Georg Lang, Shahrokh Taghavi, Walter Klepetko, Konrad Hoetzenecker, Peter Jaksch

Abstract

Alemtuzumab is a monoclonal antibody targeting CD52, increasingly used as induction therapy after transplantation. The aim of this study was to analyze the outcomes of alemtuzumab induction therapy followed by a low-dose maintenance immunosuppression in a large single-center cohort of lung transplant recipients. All patients, who received alemtuzumab induction followed by a low-dose maintenance immunosuppression were included in the analysis. Short- and long-term outcomes were analyzed. 721 lung transplant recipients, transplanted between January 2008 and June 2019, were included in this retrospective study. Freedom from higher-grade ACR at 1, 5, and 10 years was 98%, 96%, and 96%, respectively. Thirty-nine patients (5%) developed clinical AMR. Twenty-one percent of patients developed high-grade CKD. A total of 1488 infections were recorded. Sixteen percent were diagnosed within the first 3 months. Sixty-two patients (9%) developed a malignancy during follow-up. Freedom from CLAD at 1, 5, and 10 years was 94%, 72%, and 53%, respectively. Overall survival rates at 1, 5, and 10 years were 85%, 71%, and 61%, respectively. Alemtuzumab induction combined with a low-dose tacrolimus protocol is safe and associated with low rates of acute and chronic rejection, as well as an excellent long-term survival.

Keywords: alemtuzumab; immunosuppression; induction therapy; lung transplantation; rejection.

© 2021 Steunstichting ESOT. Published by John Wiley & Sons Ltd.

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Source: PubMed

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