Development and Validation of an Efficient and Highly Sensitive Enzyme-Linked Immunosorbent Assay for Alemtuzumab Quantification in Human Serum and Plasma

Abstract

Background: Alemtuzumab is a humanized monoclonal antibody that targets the CD52 glycoprotein expressed on most lymphocytes, subsequently inducing complement-mediated and antibody-mediated cytotoxicity. Owing to its ability to induce profound immune depletion, alemtuzumab is frequently used in patients before allogeneic hematopoietic stem cell transplantation to prevent graft rejection and acute graft-versus-host disease. In this clinical context, a stable immunoassay with high sensitivity and specificity to determine alemtuzumab levels is essential for performing pharmacokinetic and pharmacodynamic analyses; however, the available methods have several limitations. Here, we report the successful development and validation of an efficient and highly sensitive enzyme-linked immunosorbent assay technique based on commercially available reagents to quantify alemtuzumab in human serum or plasma.Methods: This enzyme-linked immunosorbent assay technique was developed and validated in accordance with the European Medicines Agency guidelines on bioanalytical method validation.Results: The assay sensitivity (lower limit of quantification) is 0.5 ng$mL 21 , and the dynamic range is 0.78-25 ng$mL 21 . To accom-modate quantification of peak concentration and concentrations below the lympholytic level (,0.1 mcg$mL 21 ), patients' serum samples were prediluted 20-400 times according to the expected alemtuzumab concentration. The overall within-run accuracy was between 96% and 105%, whereas overall within-run precision (coefficient of variation) was between 3% and 9%. The between-run assessment provided an overall accuracy between 86% and 95% and an overall coefficient of variation between 5% and 14%. Conclusions:The developed assay provides accurate insight into alemtuzumab exposure and its effects on the clinical response to treatment, which is key to optimizing treatment strategies.

Exposure-response analysis of alemtuzumab in pediatric allogeneic HSCT for nonmalignant diseases: the ARTIC study

“…Alemtuzumab concentrations were determined with a sensitive (lower limit of quantification, 0.0005 μg/mL) sandwich enzyme-linked immunosorbent assay as previously described by our group. 23 …”

Population pharmacokinetics of subcutaneous alemtuzumab in kidney transplantation

“…Alemtuzumab was quantified in serum using a customized enzyme‐linked immunosorbent‐based assay (ELISA) based on human anti‐alemtuzumab antibodies (NC Geoff Hale Developments, Oxford, UK) 20 . The assay was developed and validated in accordance with the European Medicines Agency guideline on bioanalytical method validation 21 using seven calibration standards ranging between 0.01 and 0.039 mg/L, and two quality controls of 0.03 and 0.12 mg/L.…”

TDM of belatacept and other biologicals in transplantation.

“…The measurement of biologicals in clinical samples faces different challenges from traditional small molecules assays, some of which are obvious given their large and complex structures. Ligand-binding assays, both commercially available and in-house developed, have been used for quantifications of mAbs, including several among the ones relevant in transplantation [2][3][4]. These methods can also be adapted to or complemented with assays for the detection of anti-drug antibodies (ADA) [3,5].…”