Comparison of outcomes following subcutaneous or intravenous alemtuzumab administered prior to reduced intensity conditioning for transplantation in pediatric sickle cell disease

IF 1.6 4区医学 Q4 IMMUNOLOGY

Transplant immunology Pub Date : 2025-02-02 DOI:10.1016/j.trim.2025.102179

Alexandra Plavsa , Tara Suresh , Stuti Dalal , Lucia Mirea , Roberta H. Adams , Shalini Shenoy , Alexander Ngwube

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Abstract

Background

Alemtuzumab-containing conditioning regimens are used for allogeneic hematopoietic stem cell transplantation (HSCT) to reduce acute and chronic graft-versus-host disease (GVHD) and the risk of graft rejection. Alemtuzumab is typically administered intravenously but is often accompanied by infusion-related side effects, including injection site reactions and anaphylaxis. Little is known about the routes of administration and if they differ in safety and efficacy in pediatric patients, especially when used in transplant conditioning.

Objectives

To compare adverse effects and efficacy outcomes between intravenous and subcutaneous alemtuzumab administration in pediatric patients with sickle cell disease who have undergone HSCT.

Study design

A retrospective cohort of 49 pediatric patients with sickle cell disease aged 4–16 years underwent HSCT and received either intravenous or subcutaneous alemtuzumab at St. Louis Children's Hospital or Phoenix Children's Hospital. The incidence of infusion-related reactions, neutrophil and platelet recovery, graft failure, and immune reconstitution were compared.

Results

We found that subcutaneous alemtuzumab administration elicited fewer infusion-related reactions than intravenously administered drug (p = 0.038). No significant differences in engraftment rates, graft failure rates, infectious complications, acute GVHD, and immune reconstitution were found between the two groups.

Conclusion

Subcutaneous administration of alemtuzumab for children undergoing transplant for sickle cell disease is safe and effective.

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小儿镰状细胞病患者在降低移植强度的调理前皮下注射或静脉注射阿仑妥珠单抗后的疗效比较

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来源期刊

Transplant immunology 医学-免疫学

CiteScore

2.10

自引率

13.30%

发文量

198

审稿时长

48 days

期刊介绍： Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.