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Pretransplant Absolute Lymphocyte Counts Impact the Pharmacokinetics of Alemtuzumab  Rebecca A. Marsh, Tsuyoshi Fukuda, Chie Emoto, Lisa Neumeier, Pooja.

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Presentation on theme: "Pretransplant Absolute Lymphocyte Counts Impact the Pharmacokinetics of Alemtuzumab  Rebecca A. Marsh, Tsuyoshi Fukuda, Chie Emoto, Lisa Neumeier, Pooja."— Presentation transcript:

1 Pretransplant Absolute Lymphocyte Counts Impact the Pharmacokinetics of Alemtuzumab 
Rebecca A. Marsh, Tsuyoshi Fukuda, Chie Emoto, Lisa Neumeier, Pooja Khandelwal, Sharat Chandra, Ashley Teusink-Cross, Alexander A. Vinks, Parinda A. Mehta  Biology of Blood and Marrow Transplantation  Volume 23, Issue 4, Pages (April 2017) DOI: /j.bbmt Copyright © 2017 The American Society for Blood and Marrow Transplantation Terms and Conditions

2 Figure 1 (A) Alemtuzumab concentrations in the pretransplant period (mean and standard deviation). (B) Correlation of day 0 alemtuzumab concentration with pre-HCT ALC. R2 = .68. Hatched lines represent 95% confidence interval. Shaded area represents previously recommend optimal therapeutic range of .2 to .4 µg/mL. *Patient was excluded from regression analysis. (C) Correlation of day 0 alemtuzumab concentration with underlying diagnosis (P < .01). (D) Correlation of alemtuzumab exposure with diagnosis. Biology of Blood and Marrow Transplantation  , DOI: ( /j.bbmt ) Copyright © 2017 The American Society for Blood and Marrow Transplantation Terms and Conditions

3 Figure 2 (A) Representative plots illustrating the effects of ALC at the start of alemtuzumab on alemtuzumab exposure in patients with ALCs of approximately 1000 lymphocytes/µL or less (top panel), 1000 to 3000 lymphocytes/µL (second panel), and >3000 lymphocytes/µL (third panel). (B) Two patients with HLH developed atypical acute rises in ALC within a week of starting alemtuzumab. One patient was treated with steroids at that time because of clinical signs of flare of HLH (ID = 6). Pink circles, lines, and fill represent ALCs and ALC area of time-count. Blue circles and lines represent alemtuzumab levels. Biology of Blood and Marrow Transplantation  , DOI: ( /j.bbmt ) Copyright © 2017 The American Society for Blood and Marrow Transplantation Terms and Conditions

4 Figure 3 Correlation of alemtuzumab exposure with ALC area of time-count. Filled circles represent patients with ALC of 3000 or more at the start of alemtuzumab. Open circles represent patients with ALC less than 3000 at the start of alemtuzumab. Square represents outlier patient excluded from analysis. Hatched lines represent 95% confidence interval. Biology of Blood and Marrow Transplantation  , DOI: ( /j.bbmt ) Copyright © 2017 The American Society for Blood and Marrow Transplantation Terms and Conditions


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