LAUSR

Alemtuzumab is a recombinant humanized anti-CD52 monoclonal antibody against a glycosylated, glycosylphosphatidylinositol-anchored, cell-surface protein (CD52) which is expressed at high levels on T and B lymphocytes. 1,2 It was approved by the European Medicines Agency in 2013 and by the Food and Drug Administration (FDA) in 2014 for relapsing remitting multiple sclerosis (RRMS) ( Lemtrada ). 2,3 Alemtuzumab is also FDA-approved for B-chronic lymphocytic leukemia (B-CLL) under the brand name Campath and used off-label for immune disorders such as graft-versus-host disease and aplastic anemia, and occasionally as a part of the conditioning regimen for solid organ and hematopoietic stem cell transplantations. 4 An interesting paradox to its immunosuppressive effects is its autoimmune effects, which are sometimes serious, warranting an FDA-issued black box warning. 2 Among the autoimmune disorders, thyroiditis (20%-40%) is the most common, followed by immune thrombocytopenia (2.2%) and autoimmune nephropathies (0.3%). 5,6 The secondary autoimmune disorders tend to arise within the fi rst 5 years of follow-up, with the peak incidence occurring in the fi rst 3 years after the last dose. 7 Rare