B-cell reconstitution and BAFF after alemtuzumab (Campath-1H) treatment of multiple sclerosis.

Abstract

INTRODUCTION:

Treatment with alemtuzumab is highly effective in relapsing-remitting multiple sclerosis; however, 30% of patients develop autoimmunity. Alemtuzumab (previously called Campath 1-H) induces a prolonged T-cell lymphopenia with memory cells dominating the reconstituting T-cell pool for at least 3 months.

RESULTS:

Here we show that B-cell recovery is rapid, returning to baseline by 3 months and rising to 165% of baseline by 12 months after treatment. Immature transitional 1 B cells are the predominant cell type 1 month after treatment. This coincides with a surge in serum B-cell activating factor (BAFF), which remains elevated by 33% for at least 12 months after alemtuzumab. BAFF is critical for transition to the mature naive B-cell phenotype, which dominates from 3 months after alemtuzumab. Differentiation to memory B cells is slow so there are radical and prolonged alterations to the B-cell pool after alemtuzumab.

• Authors: Sara A J Thompson, Joanne L Jones, Amanda L Cox, D Alastair S Compston, Alasdair J Coles
• Journal: Journal of clinical immunology (J Clin Immunol) Vol. 30 Issue 1 Pg. 99-105 (Jan 2010) ISSN: 1573-2592 [Electronic] Netherlands
• PMID: 19763798 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antibodies, Neoplasm
• B-Cell Activating Factor
• TNFSF13B protein, human
• Alemtuzumab

Topics

• Adolescent
• Adult
• Alemtuzumab
• Antibodies, Monoclonal (administration & dosage, adverse effects)
• Antibodies, Monoclonal, Humanized
• Antibodies, Neoplasm (administration & dosage, adverse effects)
• B-Cell Activating Factor (biosynthesis, blood, genetics)
• B-Lymphocytes (drug effects, immunology, metabolism, pathology)
• Cell Differentiation (drug effects)
• Cell Survival (drug effects)
• Cells, Cultured
• Female
• Follow-Up Studies
• Humans
• Immunologic Memory (drug effects)
• Immunophenotyping
• Male
• Middle Aged
• Multiple Sclerosis, Relapsing-Remitting (blood, drug therapy, immunology, pathology)
• T-Lymphocytes (drug effects, immunology, metabolism, pathology)