Alemtuzumab
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Influenza virus infection: case report A 59-year-old man developed persistent influenza virus infection following alemtuzumab treatment; he subsequently died. The man, who had previously received chemotherapy, started receiving alemtuzumab [route and dosage not stated] for chronic lymphocytic leukaemia (CLL) in October 2008. In December 2008, he experienced persistent fever and respiratory symptoms during an episode of aplasia. Alemtuzumab was discontinued and the man’s bone marrow transplantation was postponed. However, his clinical condition deteriorated. Sputum samples and blood cultures revealed the presence of Pseudomonas putida. He received antibiotics. However, his fever persisted and his clinical condition worsened. On 19 Feburary 2009, he was transferred to the haematological unit, and alemtuzumab was replaced with rituximab. He received voriconazole for suspected invasive aspergillosis. However, his condition further deteriorated and he received amphotericin B and was transferred to the ICU. Two nasopharyngeal swabs and BAL fluid samples collected between 26 February and 15 March still showed the presence of the influenza A (H3N2) virus, and he received oseltamivir. He subsequently died due to multiple organ failure on 18 March 2009. Author comment: Alemtuzumab provides hope for the treatment of CLL that is refractory to classical treatment, but severe prolonged lymphopenia may be a risk factor for virus reactivation or the development of less typical opportunistic infections. Burrel S, et al. Persistent influenza virus infection in a patient treated with alemtuzumab. Medecine et Maladies Infectieuses 40: 657-9, No. 11, Nov 2010 803057101 [French; summarised from a translation] - France
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Reactions 16 Jul 2011 No. 1360
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