The effect of treatment with Campath-1H in patients with autoimmune cytopenias

We describe 21 patients with severe and life-threatening autoimmune cytopen ias resistant to standard immunosuppression who were treated with the monoc lonal antibody Campath-1H. Four patients had autoimmune neutropenia, four h ad autoimmune haemolytic anaemia, four had pure red cell aplasia, one had i mmune thrombocytopenia purpura (ITP), three had autoimmune haemolytic anaem ia and ITP (Evan's syndrome), three had autoimmune pancytopenia (ITP, autoi mmune neutropenia and autoimmune haemolytic anaemia), one had ITP (associat ed with acquired Glarizmann's disease) and autoimmune neutropenia, and one had ITP and red cell aplasia, Campath-1H was administered at a dose of 10 m g/d as an intravenous infusion for 10 d. Responses were seen in 15 patients , which were sustained in six. Relapse occurred in eight patients after Cam path-1H treatment. Patients entering the study later, received cyclosporine after Campath-1H in an attempt to reduce the incidence of relapse. Three p atients received a second course of Campath-1H; all responded but later rel apsed. Fourteen patients are alive at a median of 12 months (range 4-61) af ter Campath-1H. Campath-1H represents an alternative therapeutic option for severe, refractory autoimmune cytopenias.