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

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    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
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    Affiliation
    Departments of Hematology, University College London Hospital, London, England.
    Issue Date
    2000-10-01
    
    Metadata
    Show full item record
    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.
    Citation
    In vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantation. 2000, 96 (7):2419-25 Blood
    Journal
    Blood
    URI
    http://hdl.handle.net/10541/86521
    PubMed ID
    11001893
    Type
    Article
    Language
    en
    ISSN
    0006-4971
    Collections
    All Christie Publications

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