Dosing and Administration

Recommended concomitant medications

Premedicate with diphenhydramine (50 mg) and acetaminophen (500 mg to 1000 mg) 30 minutes prior to first infusion and each dose escalation. Institute appropriate medical management (eg, steroids, epinephrine, meperidine) for infusion reactions as needed.

Administer trimethoprim/sulfamethoxazole DS twice daily (BID) 3 times per week (or equivalent) as Pneumocystis jiroveci pneumonia (PCP) prophylaxis.

Administer famciclovir 250 mg BID or equivalent as herpetic prophylaxis.

Continue PCP and herpes viral prophylaxis for a minimum of 2 months after completion of Campath or until the CD4+ count is ≥200 cells/µL, whichever occurs later.

Dosing schedule

Treat for 12 weeks (36 doses) as recommended for maximum bone marrow clearance

• Administer as an IV infusion over 2 hours
• Do not administer as IV push or bolus
• Gradually escalate to the maximum recommended single dose of 30 mg. Escalation is required at initiation of dosing or if dosing is held ≥7 days during treatment. Escalation to 30 mg ordinarily can be accomplished in 3-7 days
• Administer 3 mg daily until infusion reactions are ≤ grade 2
• Then administer 10 mg daily until infusion reactions are ≤ grade 2
• Then administer 30 mg/day 3 times per week on alternate days (eg, Monday-Wednesday-Friday).
• Total duration of therapy, including dose escalation, is 12 weeks
• Single doses greater than 30 mg or cumulative doses greater than 90 mg per week increase the incidence of pancytopenia

Dose modification

• Withhold Campath during serious infection or other serious adverse reactions until resolution
• Discontinue Campath for autoimmune anemia or autoimmune thrombocytopenia
• There are no dose modifications recommended for lymphopenia

Dose Modification for Neutropenia or Thrombocytopenia

Hematologic Values	Dose Modification†
ANC <250/µL and/or platelet count ≤25,000/µL
For first occurrence	Withhold Campath therapy. Resume Campath at 30 mg when ANC ≥500/µL and platelet count ≥50,000/µL
For second occurrence	Withhold Campath therapy. Resume Campath at 10 mg when ANC ≥500/µL and platelet count ≥50,000/µL
For third occurrence	Discontinue Campath therapy
≥50% decrease from baseline in patients initiating therapy with a baseline ANC ≤250/µL and/or a baseline platelet count ≤25,000/µL
For first occurrence	Withhold Campath therapy. Resume Campath at 30 mg upon return to baseline value(s)
For second occurrence	Withhold Campath therapy. Resume Campath at 10 mg upon return to baseline value(s)
For third occurrence	Discontinue Campath therapy