Abstract
Alemtuzumab is one of the first monoclonal antibodies used in cancer therapy. From the beginning of this millenium alemtuzumab was studied in the therapy of multiple sclerosis (MS), it became also part of the conditioning regimen in a study with autologous haematopoietic cell transplantation for MS.
In the same time the positive effect of alemtuzumab monotherapy has been shown in both first line therapy of RRMS and MS resistant to previous therapy in well designed clinical studies. Adverse events analysis revealed the alemtuzumab therapy in MS could be associated with development of a secondary autoimmune disease.
Except of relatively frequent autoimmune thyreoiditis the immune thrombocytopenia (ITP) in 0.8-2.8 % patients, rarely autoimmune haemolytic anaemia or immune neutropenia can occur. Median time to ITP is 24 months from the first dose of alemtuzumab, ITP is usually well responding to standard treatment, the patients achieve long lasting complete remission.
Regular both clinical examination and complete blood counts must be part of the follow up in patients with MS treated with alemtuzumab up to 48 months from the end of the therapy.