Selective depletion of bone marrow T lymphocytes with anti-CD5 monoclonal antibodies: effective prophylaxis for graft-versus-host disease in patients with hematologic malignancies.

作者: JH Antin , BE Bierer , BR Smith , J Ferrara , EC Guinan

DOI: 10.1182/BLOOD.V78.8.2139.2139

关键词:

摘要: Seventy-one patients with hematologic malignancies received bone marrow from a histocompatible sibling (n = 48) or partially matched relative 23) that had been depleted of CD5+ T cells either an anti-CD5 mooclonal antibody (MoAb) plus complement (anti-Leu1 + C) MoAb conjugated to ricin A chain (ST1 immunotoxin [ST1-IT]). These intensive chemoradiotherapy consisting cytosine arabinoside, cyclophosphamide, and fractionated total body irradiation. Both anti-Leu1 C ST1-IT ex vivo treatments effectively (97% 95%, respectively). Overall, primary late graft failure each occurred in 4% evaluable patients. The diagnosis myelodysplasia was significant risk factor for (P less than .001), if myelodysplastic were excluded, there no failures major histocompatibility complex (MHC)-matched 2 23 (8.7%) MHC-mismatched actuarial grade 4 acute graft-versus-host disease (GVHD) 23% MHC-matched 50% In patients, GVHD tended be mild treatable corticosteroids. Chronic observed 6 36 (17%) none 11 There deaths attributable the group. Epstein-Barr virus-associated lymphoproliferative disorders 3 event-free survival 38% versus 21% However, outcome is analyzed by relapse, low-risk 62% compared 11% high-risk data indicate use MoAbs can control additional strategies are required

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