Diffuse alveolar hemorrhage as an early complication of alemtuzumab treatment: A case report of a multiple sclerosis patient and an overview of 14 cases

B. R. H. Drop; D. Zemel; B. H. A. Wokke; B. W. van Oosten; S. Dik; C. O. Martins Jarnalo; P. E. Westerweel; J. W. K. de Beukelaar

doi:10.1016/j.msard.2020.102614

Diffuse alveolar hemorrhage as an early complication of alemtuzumab treatment: A case report of a multiple sclerosis patient and an overview of 14 cases

B. R. H. Drop, D. Zemel, B. H. A. Wokke, B. W. van Oosten, S. Dik, C. O. Martins Jarnalo, P. E. Westerweel, J. W. K. de Beukelaar^*

^*Corresponding author for this work

Research output: Contribution to journal › Comment/Letter to the editor › Academic

Abstract

Alemtuzumab is effective in relapsing remitting multiple sclerosis (RRMS). Serious adverse events have led to a renewed safety reassessment by the European Medicines Agency (EMA), leading to an approval under strict conditions. We report a RRMS patient experiencing diffuse alveolar hemorrhage (DAH) on day 4 of her first alemtuzumab cycle. In addition, we present an overview of the cases of alemtuzumab-induced DAH that were included in EMA's review procedure, additional well documented cases reported to the EMA and those cases reported in the literature. Combining these cases revealed striking similarities. Importantly, DAH was an early complication. All RRMS patients with known outcome showed complete recovery.

Original language	English
Article number	102614
Journal	Multiple Sclerosis and Related Disorders
Volume	47
DOIs	https://doi.org/10.1016/j.msard.2020.102614
Publication status	Published - 1 Jan 2021

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10.1016/j.msard.2020.102614

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Drop, B. R. H., Zemel, D., Wokke, B. H. A., van Oosten, B. W., Dik, S., Martins Jarnalo, C. O., Westerweel, P. E., & de Beukelaar, J. W. K. (2021). Diffuse alveolar hemorrhage as an early complication of alemtuzumab treatment: A case report of a multiple sclerosis patient and an overview of 14 cases. Multiple Sclerosis and Related Disorders, 47, [102614]. https://doi.org/10.1016/j.msard.2020.102614

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title = "Diffuse alveolar hemorrhage as an early complication of alemtuzumab treatment: A case report of a multiple sclerosis patient and an overview of 14 cases",

abstract = "Alemtuzumab is effective in relapsing remitting multiple sclerosis (RRMS). Serious adverse events have led to a renewed safety reassessment by the European Medicines Agency (EMA), leading to an approval under strict conditions. We report a RRMS patient experiencing diffuse alveolar hemorrhage (DAH) on day 4 of her first alemtuzumab cycle. In addition, we present an overview of the cases of alemtuzumab-induced DAH that were included in EMA's review procedure, additional well documented cases reported to the EMA and those cases reported in the literature. Combining these cases revealed striking similarities. Importantly, DAH was an early complication. All RRMS patients with known outcome showed complete recovery.",

keywords = "Adverse events, Alemtuzumab, Diffuse alveolar hemorrhage, Hemoptysis, Multiple sclerosis, Respiratory symptoms",

author = "Drop, {B. R. H.} and D. Zemel and Wokke, {B. H. A.} and {van Oosten}, {B. W.} and S. Dik and {Martins Jarnalo}, {C. O.} and Westerweel, {P. E.} and {de Beukelaar}, {J. W. K.}",

year = "2021",

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doi = "10.1016/j.msard.2020.102614",

language = "English",

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Drop, BRH, Zemel, D, Wokke, BHA, van Oosten, BW, Dik, S, Martins Jarnalo, CO, Westerweel, PE & de Beukelaar, JWK 2021, 'Diffuse alveolar hemorrhage as an early complication of alemtuzumab treatment: A case report of a multiple sclerosis patient and an overview of 14 cases', Multiple Sclerosis and Related Disorders, vol. 47, 102614. https://doi.org/10.1016/j.msard.2020.102614

Diffuse alveolar hemorrhage as an early complication of alemtuzumab treatment: A case report of a multiple sclerosis patient and an overview of 14 cases. / Drop, B. R. H.; Zemel, D.; Wokke, B. H. A.; van Oosten, B. W.; Dik, S.; Martins Jarnalo, C. O.; Westerweel, P. E.; de Beukelaar, J. W. K.

In: Multiple Sclerosis and Related Disorders, Vol. 47, 102614, 01.01.2021.

Research output: Contribution to journal › Comment/Letter to the editor › Academic

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T1 - Diffuse alveolar hemorrhage as an early complication of alemtuzumab treatment: A case report of a multiple sclerosis patient and an overview of 14 cases

AU - Drop, B. R. H.

AU - Zemel, D.

AU - Wokke, B. H. A.

AU - van Oosten, B. W.

AU - Dik, S.

AU - Martins Jarnalo, C. O.

AU - Westerweel, P. E.

AU - de Beukelaar, J. W. K.

PY - 2021/1/1

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N2 - Alemtuzumab is effective in relapsing remitting multiple sclerosis (RRMS). Serious adverse events have led to a renewed safety reassessment by the European Medicines Agency (EMA), leading to an approval under strict conditions. We report a RRMS patient experiencing diffuse alveolar hemorrhage (DAH) on day 4 of her first alemtuzumab cycle. In addition, we present an overview of the cases of alemtuzumab-induced DAH that were included in EMA's review procedure, additional well documented cases reported to the EMA and those cases reported in the literature. Combining these cases revealed striking similarities. Importantly, DAH was an early complication. All RRMS patients with known outcome showed complete recovery.

AB - Alemtuzumab is effective in relapsing remitting multiple sclerosis (RRMS). Serious adverse events have led to a renewed safety reassessment by the European Medicines Agency (EMA), leading to an approval under strict conditions. We report a RRMS patient experiencing diffuse alveolar hemorrhage (DAH) on day 4 of her first alemtuzumab cycle. In addition, we present an overview of the cases of alemtuzumab-induced DAH that were included in EMA's review procedure, additional well documented cases reported to the EMA and those cases reported in the literature. Combining these cases revealed striking similarities. Importantly, DAH was an early complication. All RRMS patients with known outcome showed complete recovery.

KW - Adverse events

KW - Alemtuzumab

KW - Diffuse alveolar hemorrhage

KW - Hemoptysis

KW - Multiple sclerosis

KW - Respiratory symptoms

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