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In vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantation.

Kottaridis, Panagiotis D
; 
Milligan, Donald W
; 
Chopra, Rajesh
; 
Chakraverty, Ronjon
; 
Chakrabarti, Suparno
; 
Robinson, Stephen P
; 
Peggs, Karl S
; 
Verfuerth, Stephanie
; 
Pettengell, Ruth
; 
Marsh, Judith C W
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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 nonrelapse mortality was 11%. Although longer follow-up is needed to establish the long-term remission rates, this study demonstrates that this nonmyeloablative preparative regimen is associated with durable engraftment, minimal toxicity, and low incidence of GVHD.
Authors
Kottaridis, Panagiotis D
Milligan, Donald W
Chopra, Rajesh
Chakraverty, Ronjon
Chakrabarti, Suparno
Robinson, Stephen P
Peggs, Karl S
Verfuerth, Stephanie
Pettengell, Ruth
Marsh, Judith C W
Schey, Stephen
Mahendra, Premini
Morgan, Gareth J
Hale, Geoff
Waldmann, Herman
De Elvira, M Carmen Ruiz
Williams, Catherine D
Devereux, Stephen
Linch, David C
Goldstone, Anthony H
Mackinnon, Stephen
Affiliation
Departments of Hematology, University College London Hospital, London, England.
Description
Date
2000-10-01
Publisher
Collections
All Christie Publications
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Keywords
Haematologic Cancer
Haematopoietic Stem Cell Transplantation
Type
Article
Citation
In vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantation. 2000, 96 (7):2419-25 Blood
Journal Title
Journal ISSN
Volume Title
URI
http://hdl.handle.net/10541/86521
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