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| In vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantation |
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| Author(s): Kottaridis PD, Milligan DW, Chopra R, Chakraverty RK, Chakrabarti S, Robinson S, Peggs K, Verfuerth S, Pettengell R, Marsh JCW, Schey S, Mahendra P, Morgan GJ, Hale G, Waldmann H, de Elvira MCR, Williams CD, Devereux S, Linch DC, Goldstone AH, Mackinnon S |
| Source: BLOOD Volume: 96 Issue: 7 Pages: 2419-2425 Published: OCT 1 2000 |
| Times Cited: 323 References: 28 |
| Abstract: A novel nonmyeloablative conditioning regimen was investigated in 44 patients with hematologic malignancies. The median patient age was 41 years. Many of the patients had high-risk features, including 19 patients with a previous failed transplant. Recipient conditioning consisted of CAMPATH-1H, 20 mg/day on days -8 to -4; fludarabine, 30 mg/m(2) on days -7 to -3; and melphalan, 140 mg/m(2) on day -2. Thirty-six recipients received unmanipulated granculocyte colony-stimulating factor-mobilized peripheral blood stem cells from HLA-identical siblings, and 8 received unmanipulated marrow from matched unrelated donors. GVHD prophylaxis was with cyclosporine A alone for 38 patients and cyclosporine A plus methotrexate for 6 sibling recipients. Forty-two of the 43 evaluable patients had sustained engraftment. Results of chimerism analysis using microsatellite polymerase chain reaction indicate that 18 of 31 patients studied were full-donor chimeras while the other patients were mixed chimeras in one or more lineages. At a median follow-up of 9 months (range 3 to 29 months), 33 patients remain alive in complete remission or with no evidence of disease progression. Seven patients relapsed or progressed post-transplantation, and 4 of them subsequently died. Four patients died of regimen-related complications. There were no cases of grades III-IV acute GVHD. Only 2 patients developed grade II acute GVHD, and only 1 had chronic GVHD. The estimated probability of non-relapse mortality was 11%. Although longer follow-up is needed to establish the longterm remission rates, this study demonstrates that this nonmyeloablative preparative regimen is associated with durable engraftment, minimal toxicity, and low incidence of GVHD. (Blood. 2000;96:2419-2425) (C) 2000 by The American Society of Hematology. |
| Document Type: Article |
| Language: English |
| Reprint Address: Mackinnon, S (reprint author), UCL Hosp, Dept Hematol, 98 Chenies Mews, London WC1E 6H, England |
Addresses:
1. UCL Hosp, Dept Hematol, London WC1E 6H, England
2. Birmingham Heartlands Hosp, Dept Hematol, Birmingham B9 5ST, W Midlands England
3. Christie Hosp, Dept Hematol, Manchester, Lancs England
4. Univ London St Georges Hosp, Dept Hematol, London, England
5. Guys Hosp, Dept Hematol, London SE1 9RT, England
6. Queen Elizabeth Hosp, Dept Hematol, Birmingham B15 2TH, W Midlands England
7. Leeds Gen Infirm, Dept Hematol, Leeds, W Yorkshire England
8. Univ Oxford, Therapeut Antibody Ctr, Dept Hematol, Oxford, England |
| Publisher: AMER SOC HEMATOLOGY, 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA |
| Subject Category: Hematology |
| IDS Number: 358HL |
| ISSN: 0006-4971 |
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