[PAGID] Campath reaction

[Jack Bleesing]

We use Campath extensively in our BMT unit, as part of our RIC
conditioning. We have switched from IV to SQ infusions, which has taken
care of the severe reactions, which also occurred in a minority of our
patients.


JB

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Jack J.H. Bleesing, M.D., Ph.D.
Cincinnati Children's Hospital Medical Center
Division of Hematology/Oncology
3333 Burnet Avenue, MLC 7015
Cincinnati, OH 45229
513-636-4266 (phone)
513-636-3549 (fax)
Jack.Bleesing at CCHMC.org
http://www.cincinnatichildrens.org/immunodeficiencies/


>>> cmseroogy at pediatrics.wisc.edu 07/19/07 5:17 PM >>>


Hi,

A nephrology colleague asked me about management of anaphylactic-type
reactions secondary to Campath.  Our group is using it in pediatric
patients
post-renal transplant with excellent clinical response.  The problem
that
has come up on numerous patients is this anaphylactic-type reaction with
the
second (and final infusion)--hives and wheezing.  A few patients were
given
epi with a good clinical response.  They are premedicating with H1 and
H2
antagonists as well as 5 mg/kg solumedrol an hour before campath
infusion.
The campath infusion is given over 2 hours and lengthening this worsened
the
reaction rates.  The second infusion is give 24 hours after the first
reaction.  I have no personal experience with Campath and am wondering
if
others have observed this and have been able to successfully manage it?
Regards, Chris