Document Detail


Alemtuzumab for the treatment of steroid-refractory acute graft-versus-host disease.
MedLine Citation:
PMID:  18158956     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The treatment of steroid-refractory acute graft-versus-host disease (aGVHD) remains a clinical challenge, for which no standard therapy exists. Alemtuzumab is a humanized anti-CD52 monoclonal antibody (mAb) that has been successfully used as part of conditioning regimens for hematopoietic stem cell transplantation (HSCT) to prevent GVHD. The purpose of this study was to evaluate the safety and efficacy of alemtuzumab in treating steroid-refractory aGVHD (>or=grade II) following HSCT. Eighteen patients received subcutaneous alemtuzumab 10 mg daily on 5 consecutive days. Response was assessed at day 28 following initiation of alemtuzumab. Eight patients had grade II aGVHD, 8 had grade III, and 2 had grade IV. The main organ involved was the liver in 4 patients, gastrointestinal (GI) tract in 5, skin in 3, skin and liver in 3, and skin and GI tract in 3. Fifteen patients (83%) responded to alemtuzumab, including 6 (33%) with complete response. All 3 unresponsive patients died of GVHD. Ten of 15 responders are alive at median follow-up of 11 months (range: 3-24). Infections occurred in 14 patients, including cytomegalovirus (CMV) reactivation in 11. Grade 3 neutropenia and thrombocytopenia occurred in 6 and 4 patients, respectively. Alemtuzumab was well tolerated, and induces promising response rates in steroid-refractory aGVHD.
Authors:
David Gómez-Almaguer; Guillermo J Ruiz-Argüelles; Luz del Carmen Tarín-Arzaga; Oscar González-Llano; Homero Gutiérrez-Aguirre; Olga Cantú-Rodríguez; José Jaime-Pérez; Antonio Carrasco-Yalán; Sergio Giralt
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation     Volume:  14     ISSN:  1523-6536     ISO Abbreviation:  Biol. Blood Marrow Transplant.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-26     Completed Date:  2008-01-22     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9600628     Medline TA:  Biol Blood Marrow Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  10-5     Citation Subset:  IM    
Affiliation:
Servicio de Hematología, Hospital Universitario Dr. José E. González, Universidad Autónoma Nuevo León, Monterrey, NL, México. dr_gomez@infosel.net.mx
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenal Cortex Hormones / adverse effects
Adult
Antibodies, Monoclonal / adverse effects,  therapeutic use*
Antibodies, Monoclonal, Humanized
Antibodies, Neoplasm / adverse effects,  therapeutic use*
Antigens, CD / immunology*
Antigens, Neoplasm / immunology*
Child
Child, Preschool
Female
Glycoproteins / immunology*
Graft vs Host Disease / drug therapy*
Hematopoietic Stem Cell Transplantation / adverse effects*
Humans
Infant
Injections, Subcutaneous
Kaplan-Meier Estimate
Male
Middle Aged
Transplantation, Homologous / adverse effects
Treatment Failure
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antibodies, Neoplasm; 0/Antigens, CD; 0/Antigens, Neoplasm; 0/CD52 antigen; 0/Glycoproteins; 3A189DH42V/alemtuzumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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