International Journal of Clinical and Experimental Medical Sciences

| Peer-Reviewed |

D-dimer Increasing After First Alemtuzumab Administration in a Multiple Sclerosis Patient

Received: 19 August 2019    Accepted: 04 September 2019    Published: 11 October 2019
Views:       Downloads:

Share This Article

Abstract

Alemtuzumab is a humanized anti-CD52 monoclonal antibody used for the treatment of high activity relapsing multiple sclerosis (R-MS). The most common adverse event is an infusion reaction due to cytokine-release. Autoimmunity can arise from months to years after treatment and encompasses Grave’s disease and thrombocytopenia. Recent reports of stroke, heart attack, and arterial dissection after alemtuzumab administration, in some cases within hours of infusion, led the European Medicines Agency’s (EMA's) Pharmacovigilance Risk Assessment Committee (PRAC) to a safety review of treatment with alemtuzumab. We report a D-Dimer increasing with suspected associated pulmonary embolism in an RMS patient after the first alemtuzumab administration. D-dimer test is not mandatory after alemtuzumab treatment, but its possible increase should warn the physician to select the patients with lower cardiovascular and thrombosis risk.

DOI 10.11648/j.ijcems.20190505.12
Published in International Journal of Clinical and Experimental Medical Sciences (Volume 5, Issue 5, September 2019)
Page(s) 67-69
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Multiple Sclerosis, Alemtuzumab, D-Dimer, Interleukin 6, Thrombosis, Biomarker, Manuscript

References
[1] H.-P. Hartung, O. Aktas, and A. N. Boyko, “Alemtuzumab: a new therapy for active relapsing-remitting multiple sclerosis.,” Mult. Scler., vol. 21, no. 1, pp. 22–34, Jan. 2015.
[2] Y. Hu et al., “Investigation of the mechanism of action of alemtuzumab in a human CD52 transgenic mouse model,” Immunology, vol. 128, no. 2, pp. 260–270, 2009.
[3] M. G. Wing et al., “Mechanism of first-dose cytokine-release syndrome by CAMPATH 1-H: Involvement of CD16 (FcγRIII) and CD11a/CD18 (LFA-1) on NK cells,” J. Clin. Invest., vol. 98, no. 12, pp. 2819–2826, 1996.
[4] H.-P. Hartung, O. Aktas, and A. N. Boyko, “Alemtuzumab: A new therapy for active relapsing-remitting multiple sclerosis.,” Mult. Scler., no. Figure 1, pp. 1–13, 2014.
[5] B. McCall, “Alemtuzumab to be restricted pending review, says EMA,” Lancet (London, England), 2019.
[6] “www.ehealthme.com.” [Online]. Available: https://www.ehealthme.com/ds/campath/fibrin-d-dimer-increased/. [Accessed: 06-Jun-2019].
[7] H. A. Chakkera, A. Sharif, and B. Kaplan, “Negative Cardiovascular Consequences of Small Molecule Immunosuppressants,” Clinical Pharmacology and Therapeutics, vol. 102, no. 2. pp. 269–276, 2017.
[8] B. S. Taylor et al., “HIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer,” J. Acquir. Immune Defic. Syndr., vol. 75, no. 5, pp. 500–508, 2017.
[9] R. Kerr, D. Stirling, and C. A. Ludlam, “Interleukin 6 and haemostasis,” British Journal of Haematology, vol. 115, no. 1. pp. 3–12, 2001.
[10] S. C. Robson, E. G. Shephard, and R. E. Kirsch, “Fibrin degradation product D-dimer induces the synthesis and release of biologically active IL-1β, IL-6 and plasminogen activator inhibitors from monocytes in vitro,” Br. J. Haematol., 1994.
[11] D. A. Duprez et al., “Inflammation, coagulation and cardiovascular disease in HIV-infected individuals,” PLoS One, vol. 7, no. 9, 2012.
[12] S. J. Piva et al., “Assessment of inflammatory and oxidative biomarkers in obesity and their associations with body mass index,” Inflammation, 2013.
[13] B. Grund et al., “Relevance of interleukin-6 and D-dimer for serious non-AIDS morbidity and death among HIV-positive adults on suppressive antiretroviral therapy,” PLoS One, vol. 11, no. 5, 2016.
Author Information
  • Clinical and Biological Sciences Department, University of Torino, San Luigi Gonzaga Hospital, Neurology Unit, Orbassano, Italy

  • Clinical and Biological Sciences Department, University of Torino, San Luigi Gonzaga Hospital, Neurology Unit, Orbassano, Italy

  • Clinical and Biological Sciences Department, University of Torino, San Luigi Gonzaga Hospital, Neurology Unit, Orbassano, Italy

  • Clinical and Biological Sciences Department, University of Torino, San Luigi Gonzaga Hospital, Neurology Unit, Orbassano, Italy

  • Clinical and Biological Sciences Department, University of Torino, San Luigi Gonzaga Hospital, Neurology Unit, Orbassano, Italy

  • Clinical and Biological Sciences Department, University of Torino, San Luigi Gonzaga Hospital, Neurology Unit, Orbassano, Italy

Cite This Article
  • APA Style

    Stefania Federica De Mercanti, Simona Rolla, Manuela Matta, Marco Iudicello, Emanuele Franchin, et al. (2019). D-dimer Increasing After First Alemtuzumab Administration in a Multiple Sclerosis Patient. International Journal of Clinical and Experimental Medical Sciences, 5(5), 67-69. https://doi.org/10.11648/j.ijcems.20190505.12

    Copy | Download

    ACS Style

    Stefania Federica De Mercanti; Simona Rolla; Manuela Matta; Marco Iudicello; Emanuele Franchin, et al. D-dimer Increasing After First Alemtuzumab Administration in a Multiple Sclerosis Patient. Int. J. Clin. Exp. Med. Sci. 2019, 5(5), 67-69. doi: 10.11648/j.ijcems.20190505.12

    Copy | Download

    AMA Style

    Stefania Federica De Mercanti, Simona Rolla, Manuela Matta, Marco Iudicello, Emanuele Franchin, et al. D-dimer Increasing After First Alemtuzumab Administration in a Multiple Sclerosis Patient. Int J Clin Exp Med Sci. 2019;5(5):67-69. doi: 10.11648/j.ijcems.20190505.12

    Copy | Download

  • @article{10.11648/j.ijcems.20190505.12,
      author = {Stefania Federica De Mercanti and Simona Rolla and Manuela Matta and Marco Iudicello and Emanuele Franchin and Marinella Clerico},
      title = {D-dimer Increasing After First Alemtuzumab Administration in a Multiple Sclerosis Patient},
      journal = {International Journal of Clinical and Experimental Medical Sciences},
      volume = {5},
      number = {5},
      pages = {67-69},
      doi = {10.11648/j.ijcems.20190505.12},
      url = {https://doi.org/10.11648/j.ijcems.20190505.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijcems.20190505.12},
      abstract = {Alemtuzumab is a humanized anti-CD52 monoclonal antibody used for the treatment of high activity relapsing multiple sclerosis (R-MS). The most common adverse event is an infusion reaction due to cytokine-release. Autoimmunity can arise from months to years after treatment and encompasses Grave’s disease and thrombocytopenia. Recent reports of stroke, heart attack, and arterial dissection after alemtuzumab administration, in some cases within hours of infusion, led the European Medicines Agency’s (EMA's) Pharmacovigilance Risk Assessment Committee (PRAC) to a safety review of treatment with alemtuzumab. We report a D-Dimer increasing with suspected associated pulmonary embolism in an RMS patient after the first alemtuzumab administration. D-dimer test is not mandatory after alemtuzumab treatment, but its possible increase should warn the physician to select the patients with lower cardiovascular and thrombosis risk.},
     year = {2019}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - D-dimer Increasing After First Alemtuzumab Administration in a Multiple Sclerosis Patient
    AU  - Stefania Federica De Mercanti
    AU  - Simona Rolla
    AU  - Manuela Matta
    AU  - Marco Iudicello
    AU  - Emanuele Franchin
    AU  - Marinella Clerico
    Y1  - 2019/10/11
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijcems.20190505.12
    DO  - 10.11648/j.ijcems.20190505.12
    T2  - International Journal of Clinical and Experimental Medical Sciences
    JF  - International Journal of Clinical and Experimental Medical Sciences
    JO  - International Journal of Clinical and Experimental Medical Sciences
    SP  - 67
    EP  - 69
    PB  - Science Publishing Group
    SN  - 2469-8032
    UR  - https://doi.org/10.11648/j.ijcems.20190505.12
    AB  - Alemtuzumab is a humanized anti-CD52 monoclonal antibody used for the treatment of high activity relapsing multiple sclerosis (R-MS). The most common adverse event is an infusion reaction due to cytokine-release. Autoimmunity can arise from months to years after treatment and encompasses Grave’s disease and thrombocytopenia. Recent reports of stroke, heart attack, and arterial dissection after alemtuzumab administration, in some cases within hours of infusion, led the European Medicines Agency’s (EMA's) Pharmacovigilance Risk Assessment Committee (PRAC) to a safety review of treatment with alemtuzumab. We report a D-Dimer increasing with suspected associated pulmonary embolism in an RMS patient after the first alemtuzumab administration. D-dimer test is not mandatory after alemtuzumab treatment, but its possible increase should warn the physician to select the patients with lower cardiovascular and thrombosis risk.
    VL  - 5
    IS  - 5
    ER  - 

    Copy | Download

  • Sections