Canterbury DHB

Context

Monoclonal Antibodies

In This Section

Rituximab

Alemtuzumab

Rituximab

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.

For a full discussion of the role of rituximab and other monoclonal antibodies in NHL see ASH EPB 2005 p. 329, p. 335. See also the Rituximab Data Sheets on Medsafe.

Alemtuzumab

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.

About this Canterbury DHB document (5732):

Document Owner:

Steve Gibbons and Fiona Stone (see Who's Who)

Issue Date:

March 2017

Next Review:

March 2020

Keywords:

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

Topic Code: 5732