Parenteral Manual

Alemtuzumab (Non-Formulary)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
MabCampath, Campath
Classification: 
Monoclonal antibody, immunosuppressant
Original Date: 
January 2020
Indications: 
  • B-cell chronic lymphocytic leukemia (B-CLL)
  • Experimental use for the prophylaxis of graft versus host disease (GVHD) in stem cell transplant, and for refractory hemophagocytic lymphohistiocytosis (HLH)
Reconstitution and Stability: 
  • Supplied as a 1 mL single-use vial containing 30 mg of alemtuzumab
  • Refrigerate unused vials
  • DO NOT SHAKE the vial or prepared product
  • Dilute in 100 mL of 0.9%NaCl or D5W. GENTLY INVERT the bag to mix the solution.
  • Diluted solution stable for 8 hours at room temperature or refrigerated
  • Protect from light
Compatibility: 
  • Solution Compatible: 0.9%NaCl, D5W
  • Do not mix with any other drugs or solutions
Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC Yes
IM No
IV direct No
IV intermittent infusion

Yes, preferred

Usual concentration < 0.3 mg/mL

Infuse over 2-6 hours

IV continuous infusion No

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

  • HLH: 1 mg/kg total, divided over 4-6 days with initial dose of 0.06 mg/kg (max= 3 mg) followed by a daily dose escalating schedule

Adult:

  • B-CLL: initial: 3 mg IV daily until tolerated, then escalate to 10 mg until tolerated, then escalate to the maintenance dose of 30 mg IV three times weekly on alternate days
Potential hazards of parenteral administration: 
  • Infusion reactions:
    • Premedication with an oral antihistamine and acetaminophen prior to each dose, and close monitoring highly recommended.  Corticosteroids may be used in addition to an antihistamine and acetaminophen
    • Infusion reaction may include: pyrexia, chills/rigors, nausea, hypotension, urticaria, dyspnea, rash, emesis, bronchospasm
      • Meperidine may be used to treat rigors
    • For severe infusion related symptoms, stop alemtuzumab infusion and administer hydrocortisone
    • For persistent acute infusion reactions, infusion time may be extended to up to 8 hours from the time of dose preparation
Notes: 
  • Alemtuzumab is not a vesicant
References: 

- Lexicomp. Alemtuzumab Product Monograph. Accessed 28Jan2020

- Sanofi Genzyme. MabCampath Product Monograph. Accessed 28Jan2020.

- BC Cancer Chemotherapy Preparation and Stability Chart v2. Accessed 28Jan2020.

- Marsh et al. Salvage Therapy of Refractory Hemophagocytic Lymphohistiocytosis with Alemtuzumab. Pediatr Blood Cancer. 2013 Jan; 60(1): 101-109

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.