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XomaZyme-CD5 immunotoxin in conjunction with partial T cell depletion for prevention of graft rejection and graft-versus-host disease after bone marrow transplantation from matched unrelated donors.
Bone Marrow Transplant. 1994 May; 13(5):571-5.BM

Abstract

Patients who receive bone marrow transplants from unrelated donors have a high incidence of graft-versus-host disease (GVHD). If the donor marrow is first T cell-depleted, the everity of GVHD declines but the risk of rejection rises. In an attempt to prevent both graft rejection and GVHD, we included an anti-T cell antibody-toxin conjugate (CD-5-Ricin; XomaZyme H65) in the transplant conditioning regimen. After receiving a partially T cell-depleted marrow, patients then received a second course of immunotoxin as additional GVHD prophylaxis. Eight recipients of unrelated donor marrow transplants were studied. All engrafted (ANC > 500 x 10(6)/l by day 15, range 13-20 days). One patient had grade II skin GVHD and one developed grade IV disease but the other six patients had no acute GVHD. However, there was high morbidity and mortality from virus infections associated with a sluggish return of CD4 and CD8 T cells into the normal range. Four patients died from virus disease (CMV, n = 2; EBV, n = 1; adenovirus, n = 1) and the remaining patients had frequent documented viral illnesses during the first year. We conclude that improvement in the outcome of unrelated donor marrow transplantation will require strategies which prevent rejection and GVHD coupled with attempts to accelerate immune reconstitution.

Authors+Show Affiliations

Koehler M
Division of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, TN 38103.
Hurwitz CA
No affiliation info available
Krance RA
No affiliation info available
Coustan-Smith E
No affiliation info available
Williams LL
No affiliation info available
Santana V
No affiliation info available
Ribeiro RC
No affiliation info available
Brenner MK
No affiliation info available
Heslop HE
No affiliation info available

MeSH

AdolescentAdultAntibodies, MonoclonalAntigens, CDBone Marrow TransplantationCD5 AntigensChildChild, PreschoolFemaleGraft RejectionGraft vs Host DiseaseHumansImmunotoxinsLeukemiaLymphocyte DepletionMaleRicinT-Lymphocytes

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

7519937

Citation

Koehler, M, et al. "XomaZyme-CD5 Immunotoxin in Conjunction With Partial T Cell Depletion for Prevention of Graft Rejection and Graft-versus-host Disease After Bone Marrow Transplantation From Matched Unrelated Donors." Bone Marrow Transplantation, vol. 13, no. 5, 1994, pp. 571-5.
Koehler M, Hurwitz CA, Krance RA, et al. XomaZyme-CD5 immunotoxin in conjunction with partial T cell depletion for prevention of graft rejection and graft-versus-host disease after bone marrow transplantation from matched unrelated donors. Bone Marrow Transplant. 1994;13(5):571-5.
Koehler, M., Hurwitz, C. A., Krance, R. A., Coustan-Smith, E., Williams, L. L., Santana, V., Ribeiro, R. C., Brenner, M. K., & Heslop, H. E. (1994). XomaZyme-CD5 immunotoxin in conjunction with partial T cell depletion for prevention of graft rejection and graft-versus-host disease after bone marrow transplantation from matched unrelated donors. Bone Marrow Transplantation, 13(5), 571-5.
Koehler M, et al. XomaZyme-CD5 Immunotoxin in Conjunction With Partial T Cell Depletion for Prevention of Graft Rejection and Graft-versus-host Disease After Bone Marrow Transplantation From Matched Unrelated Donors. Bone Marrow Transplant. 1994;13(5):571-5. PubMed PMID: 7519937.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - XomaZyme-CD5 immunotoxin in conjunction with partial T cell depletion for prevention of graft rejection and graft-versus-host disease after bone marrow transplantation from matched unrelated donors. AU - Koehler,M, AU - Hurwitz,C A, AU - Krance,R A, AU - Coustan-Smith,E, AU - Williams,L L, AU - Santana,V, AU - Ribeiro,R C, AU - Brenner,M K, AU - Heslop,H E, PY - 1994/5/1/pubmed PY - 1994/5/1/medline PY - 1994/5/1/entrez SP - 571 EP - 5 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 13 IS - 5 N2 - Patients who receive bone marrow transplants from unrelated donors have a high incidence of graft-versus-host disease (GVHD). If the donor marrow is first T cell-depleted, the everity of GVHD declines but the risk of rejection rises. In an attempt to prevent both graft rejection and GVHD, we included an anti-T cell antibody-toxin conjugate (CD-5-Ricin; XomaZyme H65) in the transplant conditioning regimen. After receiving a partially T cell-depleted marrow, patients then received a second course of immunotoxin as additional GVHD prophylaxis. Eight recipients of unrelated donor marrow transplants were studied. All engrafted (ANC > 500 x 10(6)/l by day 15, range 13-20 days). One patient had grade II skin GVHD and one developed grade IV disease but the other six patients had no acute GVHD. However, there was high morbidity and mortality from virus infections associated with a sluggish return of CD4 and CD8 T cells into the normal range. Four patients died from virus disease (CMV, n = 2; EBV, n = 1; adenovirus, n = 1) and the remaining patients had frequent documented viral illnesses during the first year. We conclude that improvement in the outcome of unrelated donor marrow transplantation will require strategies which prevent rejection and GVHD coupled with attempts to accelerate immune reconstitution. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/7519937/XomaZyme_CD5_immunotoxin_in_conjunction_with_partial_T_cell_depletion_for_prevention_of_graft_rejection_and_graft_versus_host_disease_after_bone_marrow_transplantation_from_matched_unrelated_donors_ L2 - http://www.diseaseinfosearch.org/result/7171 DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓4]

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