Alemtuzumab
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Pure red cell aplasia: case report A 62-year-old man developed pure red cell aplasia while receiving alemtuzumab for chronic lymphocytic leukaemia. The man’s disease relapsed and he began receiving alemtuzumab [Campath-1H; dosage not stated]. About 4 weeks after treatment initiation, he was hospitalised for a pyrexial episode. On admission, he had a mean haemoglobin level of 6.9 g/dL (9.0–10.0 g/dL before alemtuzumab treatment), a WBC count of 2.0 x 109/L (26–29 x 109/L before treatment) a lymphocyte count of 0.19 x 109/L (22–25 x 109/L before treatment) and a platelet count of 29 x 109/L (40–50 x 109/L before treatment). Over a 7-day period, the man required 11 blood transfusions for symptomatic anaemia. Investigations for haemolytic anaemia showed a weakly positive direct antiglobin test against complement. A bone marrow examination showed pure red cell aplasia with reduced megakaryopoiesis. A trephine biopsy confirmed the results with few lymphoid aggregates. He began receiving prednisolone, and also received immunoglobulin for 2 days. His anaemia considerably improved. After 2 weeks, his prednisolone dosage was tapered and, after 2 months, prednisolone was stopped. After 6 months, he had another relapse, but his haemoglobin level remained stable over 11g% [sic]. Author comment: "It is more likely that in our patient, [alemtuzumab] rather than [chronic lymphocytic leukaemia] would have contributed to the development of [pure red cell aplasia]." Thachil J, et al. Campath-1H induced pure red cell aplasia in a patient with chronic lymphatic leukaemia. Leukemia Research 31: 1025-1026, No. 7, Jul 2007 - United 801094466 Kingdom
0114-9954/10/1164-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 11 Aug 2007 No. 1164
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