Neutropenia with fatal outcome in a multiple sclerosis patient 23 days after alemtuzumab infusion

A 47-year-old Caucasian female with relapsing- remitting Multiple Sclerosis, received alemtuzumab after a serious relapse. She had ceased receiving any treatment during the previous year. 23 days after alemtuzumab infusion she developed severe early neutropenia, which resulted in septic shock by Staphylococcus aureus and death. This is the first report of alemtuzumab infusion-related death due to early neutropenia in non-immunocompromised MS patients. We suggest that the long existing safety guidelines for alemtuzumab infusion in B-cell chronic lymphocytic leukemia might be also beneficial in the MS setting. Weekly blood test for the first two months after the first infusion could prevent major infections.