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

Received: 19 August 2019     Accepted: 4 September 2019     Published: 11 October 2019
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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.

Published in International Journal of Clinical and Experimental Medical Sciences (Volume 5, Issue 5)
DOI 10.11648/j.ijcems.20190505.12
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), 2019. Published by Science Publishing Group

Keywords

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

References
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[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.
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[5] B. McCall, “Alemtuzumab to be restricted pending review, says EMA,” Lancet (London, England), 2019.
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[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.
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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

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    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

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    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

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  • @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://article.sciencepublishinggroup.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}
    }
    

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    AU  - Stefania Federica De Mercanti
    AU  - Simona Rolla
    AU  - Manuela Matta
    AU  - Marco Iudicello
    AU  - Emanuele Franchin
    AU  - Marinella Clerico
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    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
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    PB  - Science Publishing Group
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    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  - 

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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

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