Canterbury DHB


Monoclonal Antibodies

In This Section





Rituximab, a humanised anti CD20 monoclonal antibody, was approved for use overseas in indolent lymphomas in 1997. Since then, Rituximab has been used widely in all types of B-cell CD20 positive lymphomas. It has also been effective in a number of non-malignant conditions when immunosuppression combined with low toxicity is required.


Alemtuzumab, a humanised anti CD52 monoclonal antibody, is licensed as a third line treatment for B cell CLL.

Standard treatment involves a subcutaneous injection (unlicensed) or IV infusion three days a week, starting at 3 mg and progressing to 10 mg and finally 30 mg as infusion-related reactions allow. For intravenous infusions, premedication with hydrocortisone 100 mg, chlorphenamine 10mg, and paracetamol 1000 mg is recommended to minimise the infusion-related reactions. Dose escalation should not occur until the current dose is tolerated. Additionally, if treatment is delayed by more than a week, then dose titration should be restarted.

Cutaneous skin reactions are more prevalent with subcutaneous administration.

Alemtuzumab administration is currently the preferred method of T cell depletion prior to allogeneic stem cell transplant. For more information and specific dosing regimen, see the individual transplant protocol.

Alemtuzumab is only available via a compassionate use scheme. Contact the haematology pharmacist for the application paperwork and to coordinate supply.


Obinutuzumab is a humanised anti-CD20 monoclonal antibody indicated and funded for treatment of chronic lymphocytic leukaemia for patients not eligible for full dose FCR treatment. It is also indicated for, but not funded for indolent NHL.

Obinutuzumab has a high rate of immune reactions, so patients will be admitted to B6 for the administration of their first dose. This first dose of 1000 mg will be split over 2 days, with 100 mg given on day 1 and 900 mg given on day 2. Patients also receive pre-medications with methylprednisolone, loratadine and paracetamol. Subsequent infusions are usually well tolerated and are given in the Haematology Day Ward.

About this Canterbury DHB document (5732):

Document Owner:

Timothy Vincent (see Who's Who)

Last Reviewed:

March 2020

Next Review:

March 2023


Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5732