Grafalon (Anti-T Lymphocyte Immunoglobulin For Human Use, Rabbit)

Grafalon is employed as an immunosuppressive agent in clinical settings where T‑cell depletion is desired. It is commonly used in the following contexts:

• Induction of immunosuppression prior to solid organ transplantation.
• Treatment of acute cellular rejection episodes after transplantation.
• Management of severe aplastic anemia resistant to conventional therapy.
• Adjunct therapy in certain autoimmune disorders requiring profound T‑cell suppression.
• Conditioning regimen for hematopoietic stem cell transplantation.

Side effects of Grafalon vary in frequency and severity. Common reactions are typically mild to moderate, while serious events are less frequent but require prompt medical attention.

Common

• Fever, chills, or rigors during infusion.
• Nausea, vomiting, or abdominal discomfort.
• Headache or dizziness.
• Transient hypotension or hypertension.
• Rash, pruritus, or mild urticaria.
• Elevated liver enzymes.

Serious

• Serum sickness–like reactions.
• Severe infection due to immunosuppression.
• Cytokine release syndrome.
• Anaphylaxis or severe hypersensitivity.
• Acute renal impairment.
• Thromboembolic events.

Grafalon should be administered with careful consideration of patient‑specific factors and monitoring requirements. Important precautions include:

• Screening for active infections (e.g., hepatitis, HIV, tuberculosis) before initiation.
• Baseline and periodic assessment of complete blood count, renal and hepatic function.
• Avoid use in patients with known hypersensitivity to rabbit proteins.
• Pregnancy and lactation status should be evaluated; safety data are limited.
• Monitor for signs of cytokine release or serum sickness during and after infusion.
• Ensure appropriate vaccination status; avoid live vaccines while immunosuppressed.

Grafalon may interact with other agents that affect immune function or hemostasis. Consider the following when co‑administering:

Avoid

• Concurrent use of other potent immunosuppressants without dose adjustment (e.g., high‑dose steroids, calcineurin inhibitors).
• Live attenuated vaccines during treatment.

Use with caution

• Nephrotoxic drugs (e.g., aminoglycosides, amphotericin B).
• Anticoagulants or antiplatelet agents, due to potential bleeding risk.
• Other biologic agents targeting lymphocytes.
• Medications that may exacerbate hypertension or hypotension.