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J Clin Immunol. 2010 Jan;30(1):99-105. doi: 10.1007/s10875-009-9327-3. Epub 2009 Sep 10.

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

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Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.



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.


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.

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