In vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantation.
AuthorsKottaridis, Panagiotis D
Milligan, Donald W
Robinson, Stephen P
Peggs, Karl S
Marsh, Judith C W
Morgan, Gareth J
De Elvira, M Carmen Ruiz
Williams, Catherine D
Linch, David C
Goldstone, Anthony H
AffiliationDepartments of Hematology, University College London Hospital, London, England.
MetadataShow full item record
AbstractA 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.
CitationIn vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantation. 2000, 96 (7):2419-25 Blood
- In vivo CAMPATH-1H prevents GvHD following nonmyeloablative stem-cell transplantation.
- Authors: Kottaridis PD, Milligan DW, Chopra R, Chakraverty RK, Chakrabarti S, Robinson S, Peggs K, Verfuerth S, Pettengell R, Marsh JC, Schey S, Mahendra P, Morgan GJ, Hale G, Waldmann H, Ruiz de Elvira MC, Williams CD, Devereux S, Linch DC, Goldstone AH, MacKinnon S
- Issue date: 2001
- A study of a reduced-intensity conditioning regimen followed by allogeneic stem cell transplantation for patients with hematologic malignancies using Campath-1H as part of a graft-versus-host disease strategy.
- Authors: Shore T, Harpel J, Schuster MW, Roboz GJ, Leonard JP, Coleman M, Feldman EJ, Silver RT
- Issue date: 2006 Aug
- The toxicity and efficacy of donor lymphocyte infusions given after reduced-intensity conditioning allogeneic stem cell transplantation.
- Authors: Marks DI, Lush R, Cavenagh J, Milligan DW, Schey S, Parker A, Clark FJ, Hunt L, Yin J, Fuller S, Vandenberghe E, Marsh J, Littlewood T, Smith GM, Culligan D, Hunter A, Chopra R, Davies A, Towlson K, Williams CD
- Issue date: 2002 Nov 1
- Successful treatment of stem cell graft failure in pediatric patients using a submyeloablative regimen of campath-1H and fludarabine.
- Authors: Ahmed N, Leung KS, Rosenblatt H, Bollard CM, Gottschalk S, Myers GD, Carrum G, Heslop HE, Brenner MK, Krance RA
- Issue date: 2008 Nov
- Limiting transplantation-related mortality following unrelated donor stem cell transplantation by using a nonmyeloablative conditioning regimen.
- Authors: Chakraverty R, Peggs K, Chopra R, Milligan DW, Kottaridis PD, Verfuerth S, Geary J, Thuraisundaram D, Branson K, Chakrabarti S, Mahendra P, Craddock C, Parker A, Hunter A, Hale G, Waldmann H, Williams CD, Yong K, Linch DC, Goldstone AH, Mackinnon S
- Issue date: 2002 Feb 1