In vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantation.
dc.contributor.author | Kottaridis, Panagiotis D | |
dc.contributor.author | Milligan, Donald W | |
dc.contributor.author | Chopra, Rajesh | |
dc.contributor.author | Chakraverty, Ronjon | |
dc.contributor.author | Chakrabarti, Suparno | |
dc.contributor.author | Robinson, Stephen P | |
dc.contributor.author | Peggs, Karl S | |
dc.contributor.author | Verfuerth, Stephanie | |
dc.contributor.author | Pettengell, Ruth | |
dc.contributor.author | Marsh, Judith C W | |
dc.contributor.author | Schey, Stephen | |
dc.contributor.author | Mahendra, Premini | |
dc.contributor.author | Morgan, Gareth J | |
dc.contributor.author | Hale, Geoff | |
dc.contributor.author | Waldmann, Herman | |
dc.contributor.author | De Elvira, M Carmen Ruiz | |
dc.contributor.author | Williams, Catherine D | |
dc.contributor.author | Devereux, Stephen | |
dc.contributor.author | Linch, David C | |
dc.contributor.author | Goldstone, Anthony H | |
dc.contributor.author | Mackinnon, Stephen | |
dc.date.accessioned | 2009-11-19T16:52:44Z | |
dc.date.available | 2009-11-19T16:52:44Z | |
dc.date.issued | 2000-10-01 | |
dc.identifier.citation | In vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantation. 2000, 96 (7):2419-25 Blood | en |
dc.identifier.issn | 0006-4971 | |
dc.identifier.pmid | 11001893 | |
dc.identifier.uri | http://hdl.handle.net/10541/86521 | |
dc.description.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. | |
dc.language.iso | en | en |
dc.subject | Haematologic Cancer | en |
dc.subject | Haematopoietic Stem Cell Transplantation | en |
dc.subject.mesh | Adolescent | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Antibodies, Monoclonal | |
dc.subject.mesh | Antibodies, Neoplasm | |
dc.subject.mesh | Antineoplastic Agents | |
dc.subject.mesh | Cyclosporine | |
dc.subject.mesh | Drug Therapy, Combination | |
dc.subject.mesh | Female | |
dc.subject.mesh | Graft vs Host Disease | |
dc.subject.mesh | Granulocyte Colony-Stimulating Factor | |
dc.subject.mesh | Hematologic Neoplasms | |
dc.subject.mesh | Hematopoietic Stem Cell Transplantation | |
dc.subject.mesh | Histocompatibility Testing | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Immunosuppressive Agents | |
dc.subject.mesh | Male | |
dc.subject.mesh | Melphalan | |
dc.subject.mesh | Methotrexate | |
dc.subject.mesh | Microsatellite Repeats | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Nuclear Family | |
dc.subject.mesh | Polymerase Chain Reaction | |
dc.subject.mesh | Recurrence | |
dc.subject.mesh | Transplantation Chimera | |
dc.subject.mesh | Transplantation Conditioning | |
dc.subject.mesh | Treatment Outcome | |
dc.subject.mesh | Vidarabine | |
dc.title | In vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantation. | en |
dc.type | Article | en |
dc.contributor.department | Departments of Hematology, University College London Hospital, London, England. | en |
dc.identifier.journal | Blood | en |
html.description.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. |