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


Journal of Clinical & Cellular Immunology

Author(s): Thompson SA, Jones JL, Cox AL, Compston DA, Coles AJ

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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. This article was published in J Clin Immunol and referenced in Journal of Clinical & Cellular Immunology

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