Campath 1H allows low-dose cyclosporine monotherapy in 31 cadaveric renal allograft recipients

Background. Campath 1H is a depleting, humanized anti-CD52 monoclonal antib ody that has now been used in 31 renal allograft recipients. The results ha ve been very encouraging and are presented herein. Methods. Campath 1H was administered, intravenously, in a dose of 20 mg, on day 0 and day 1 after r enal transplant. Low-dose cyclosporine (Neoral) was then initiated at 72 hr after transplant. These patients were maintained on low-dose monotherapy w ith cyclosporine. Results. At present, the mean follow-up is 21 months (range: 15-28 months). All but one patient are alive and 29 have intact functioning grafts. There have been six separate episodes of steroid-responsive rejection. One patie nt has had a recurrence of her original disease. Two patients have suffered from opportunistic infections, which responded to therapy. One patient has died secondary to ischemic cardiac failure. Conclusions. Campath 1H has resulted in acceptable outcomes in this group o f renal allograft recipients. This novel therapy is of equal efficacy compa red to conventional triple therapy, but allows the patient to be steroid-fr ee and to be maintained on very-low-dose immunosuppressive monotherapy.