Alemtuzumab Induction in Kidney Transplantation: Clinical Results and Impact on T-Regulatory Cells

J. Morales, M. R. Bono, A. Fierro, R. Iñiguez, C. Zehnder, M. Rosemblatt, L. Calabran, C. Herzog, D. Benavente, J. Aguiló, J. Pefaur, A. Alba, M. Ferrario, W. Simon, L. Contreras, E. Buckel

Resultado de la investigación: Article

19 Citas (Scopus)

Resumen

Alemtuzumab (ALT), a humanized monoclonal anti-CD52 antibody, was introduced in solid organ transplantation as an induction agent. ALT associated with anticalcineurins has provided a low incidence of acute rejection episodes (ARE) and potential tolerogenic properties. We analyzed the clinical outcomes and effects on peripheral Treg of renal transplant recipients treated with ALT. Six-month data on kidney alone or kidney combined with pancreas or liver patients treated with ALT and tacrolimus (TAC) in standard doses were compared with those on renal transplant recipients of similar demography who were not treated with ALT. We evaluated patient and graft survivals, ARE incidence, hematological parameters, renal function, adverse events, and CD4+CD25+FoxP3+ T cells in peripheral blood. Demographics of recipients, donors, and transplants were similar in both groups. Mean HLA mismatch was slightly greater among ALT-treated patients (3.5 vs 2.5). No combined transplantation was performed in the ALT-untreated group. Patient and graft survivals were 100% without rejection or serious infections in both groups. ALT-treated recipients showed anemia and leukopenia in 3 patients as well as severe lymphopenia in 5 recipients, who partially recovered on day 90. Final mean plasma creatinine was 1.4 mg/dL, while calculated creatinine clearance was approximately 65 mL/min in both groups. Mean Treg cell percentage was higher among ALT-treated recipients than the comparative group or healthy controls (P < .05). In conclusion, renal transplantation results obtained using ALT with rigorous immunosuppressive therapy were excellent; serious adverse events and acute rejection were absent. The effect of the increased proportion of Treg cells must be evaluated with longer observation.

Idioma originalEnglish
Páginas (desde-hasta)3223-3228
Número de páginas6
PublicaciónTransplantation Proceedings
Volumen40
N.º9
DOI
EstadoPublished - nov 2008

Huella dactilar

Regulatory T-Lymphocytes
Kidney Transplantation
Kidney
Graft Survival
Creatinine
Demography
alemtuzumab
Lymphopenia
Incidence
Leukopenia
Tacrolimus
Organ Transplantation
Immunosuppressive Agents
Anemia
Pancreas
Anti-Idiotypic Antibodies
Transplantation
Monoclonal Antibodies
Observation
Tissue Donors

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Citar esto

Morales, J. ; Bono, M. R. ; Fierro, A. ; Iñiguez, R. ; Zehnder, C. ; Rosemblatt, M. ; Calabran, L. ; Herzog, C. ; Benavente, D. ; Aguiló, J. ; Pefaur, J. ; Alba, A. ; Ferrario, M. ; Simon, W. ; Contreras, L. ; Buckel, E. / Alemtuzumab Induction in Kidney Transplantation : Clinical Results and Impact on T-Regulatory Cells. En: Transplantation Proceedings. 2008 ; Vol. 40, N.º 9. pp. 3223-3228.
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title = "Alemtuzumab Induction in Kidney Transplantation: Clinical Results and Impact on T-Regulatory Cells",
abstract = "Alemtuzumab (ALT), a humanized monoclonal anti-CD52 antibody, was introduced in solid organ transplantation as an induction agent. ALT associated with anticalcineurins has provided a low incidence of acute rejection episodes (ARE) and potential tolerogenic properties. We analyzed the clinical outcomes and effects on peripheral Treg of renal transplant recipients treated with ALT. Six-month data on kidney alone or kidney combined with pancreas or liver patients treated with ALT and tacrolimus (TAC) in standard doses were compared with those on renal transplant recipients of similar demography who were not treated with ALT. We evaluated patient and graft survivals, ARE incidence, hematological parameters, renal function, adverse events, and CD4+CD25+FoxP3+ T cells in peripheral blood. Demographics of recipients, donors, and transplants were similar in both groups. Mean HLA mismatch was slightly greater among ALT-treated patients (3.5 vs 2.5). No combined transplantation was performed in the ALT-untreated group. Patient and graft survivals were 100{\%} without rejection or serious infections in both groups. ALT-treated recipients showed anemia and leukopenia in 3 patients as well as severe lymphopenia in 5 recipients, who partially recovered on day 90. Final mean plasma creatinine was 1.4 mg/dL, while calculated creatinine clearance was approximately 65 mL/min in both groups. Mean Treg cell percentage was higher among ALT-treated recipients than the comparative group or healthy controls (P < .05). In conclusion, renal transplantation results obtained using ALT with rigorous immunosuppressive therapy were excellent; serious adverse events and acute rejection were absent. The effect of the increased proportion of Treg cells must be evaluated with longer observation.",
author = "J. Morales and Bono, {M. R.} and A. Fierro and R. I{\~n}iguez and C. Zehnder and M. Rosemblatt and L. Calabran and C. Herzog and D. Benavente and J. Aguil{\'o} and J. Pefaur and A. Alba and M. Ferrario and W. Simon and L. Contreras and E. Buckel",
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Morales, J, Bono, MR, Fierro, A, Iñiguez, R, Zehnder, C, Rosemblatt, M, Calabran, L, Herzog, C, Benavente, D, Aguiló, J, Pefaur, J, Alba, A, Ferrario, M, Simon, W, Contreras, L & Buckel, E 2008, 'Alemtuzumab Induction in Kidney Transplantation: Clinical Results and Impact on T-Regulatory Cells', Transplantation Proceedings, vol. 40, n.º 9, pp. 3223-3228. https://doi.org/10.1016/j.transproceed.2008.03.066

Alemtuzumab Induction in Kidney Transplantation : Clinical Results and Impact on T-Regulatory Cells. / Morales, J.; Bono, M. R.; Fierro, A.; Iñiguez, R.; Zehnder, C.; Rosemblatt, M.; Calabran, L.; Herzog, C.; Benavente, D.; Aguiló, J.; Pefaur, J.; Alba, A.; Ferrario, M.; Simon, W.; Contreras, L.; Buckel, E.

En: Transplantation Proceedings, Vol. 40, N.º 9, 11.2008, p. 3223-3228.

Resultado de la investigación: Article

TY - JOUR

T1 - Alemtuzumab Induction in Kidney Transplantation

T2 - Clinical Results and Impact on T-Regulatory Cells

AU - Morales, J.

AU - Bono, M. R.

AU - Fierro, A.

AU - Iñiguez, R.

AU - Zehnder, C.

AU - Rosemblatt, M.

AU - Calabran, L.

AU - Herzog, C.

AU - Benavente, D.

AU - Aguiló, J.

AU - Pefaur, J.

AU - Alba, A.

AU - Ferrario, M.

AU - Simon, W.

AU - Contreras, L.

AU - Buckel, E.

PY - 2008/11

Y1 - 2008/11

N2 - Alemtuzumab (ALT), a humanized monoclonal anti-CD52 antibody, was introduced in solid organ transplantation as an induction agent. ALT associated with anticalcineurins has provided a low incidence of acute rejection episodes (ARE) and potential tolerogenic properties. We analyzed the clinical outcomes and effects on peripheral Treg of renal transplant recipients treated with ALT. Six-month data on kidney alone or kidney combined with pancreas or liver patients treated with ALT and tacrolimus (TAC) in standard doses were compared with those on renal transplant recipients of similar demography who were not treated with ALT. We evaluated patient and graft survivals, ARE incidence, hematological parameters, renal function, adverse events, and CD4+CD25+FoxP3+ T cells in peripheral blood. Demographics of recipients, donors, and transplants were similar in both groups. Mean HLA mismatch was slightly greater among ALT-treated patients (3.5 vs 2.5). No combined transplantation was performed in the ALT-untreated group. Patient and graft survivals were 100% without rejection or serious infections in both groups. ALT-treated recipients showed anemia and leukopenia in 3 patients as well as severe lymphopenia in 5 recipients, who partially recovered on day 90. Final mean plasma creatinine was 1.4 mg/dL, while calculated creatinine clearance was approximately 65 mL/min in both groups. Mean Treg cell percentage was higher among ALT-treated recipients than the comparative group or healthy controls (P < .05). In conclusion, renal transplantation results obtained using ALT with rigorous immunosuppressive therapy were excellent; serious adverse events and acute rejection were absent. The effect of the increased proportion of Treg cells must be evaluated with longer observation.

AB - Alemtuzumab (ALT), a humanized monoclonal anti-CD52 antibody, was introduced in solid organ transplantation as an induction agent. ALT associated with anticalcineurins has provided a low incidence of acute rejection episodes (ARE) and potential tolerogenic properties. We analyzed the clinical outcomes and effects on peripheral Treg of renal transplant recipients treated with ALT. Six-month data on kidney alone or kidney combined with pancreas or liver patients treated with ALT and tacrolimus (TAC) in standard doses were compared with those on renal transplant recipients of similar demography who were not treated with ALT. We evaluated patient and graft survivals, ARE incidence, hematological parameters, renal function, adverse events, and CD4+CD25+FoxP3+ T cells in peripheral blood. Demographics of recipients, donors, and transplants were similar in both groups. Mean HLA mismatch was slightly greater among ALT-treated patients (3.5 vs 2.5). No combined transplantation was performed in the ALT-untreated group. Patient and graft survivals were 100% without rejection or serious infections in both groups. ALT-treated recipients showed anemia and leukopenia in 3 patients as well as severe lymphopenia in 5 recipients, who partially recovered on day 90. Final mean plasma creatinine was 1.4 mg/dL, while calculated creatinine clearance was approximately 65 mL/min in both groups. Mean Treg cell percentage was higher among ALT-treated recipients than the comparative group or healthy controls (P < .05). In conclusion, renal transplantation results obtained using ALT with rigorous immunosuppressive therapy were excellent; serious adverse events and acute rejection were absent. The effect of the increased proportion of Treg cells must be evaluated with longer observation.

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JO - Transplantation Proceedings

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SN - 0041-1345

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