Author response: Rare side effects of alemtuzumab remind us of the need for postmarketing surveillance

We thank Drs. Whiteside and Trip for their comment on our editorial.¹ The authors highlight noninfectious pneumonitis as a rare potential complication of alemtuzumab.^2,3 The time course of onset in the 2 reported cases was different, with symptoms developing a few days or 1 month after infusion. Although not proven, this suggestion of immune-mediated mechanisms seem reasonable.² This reaction may arise from antibody-dependent cell-mediated or complement-mediated cytolysis, which leads to cytokine release and then type III/IV hypersensitivity reaction and lung-resident T-cell activation. As for the side effects highlighted in our editorial,¹ clinicians should recognize noninfectious pneumonitis as a potential rare complication of alemtuzumab, as it can respond well to corticosteroids.

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