1. Evaluation of anti-CD5 ricin A chain immunoconjugate for prevention of acute graft-vs.-host disease after HLA-identical marrow transplantation.
- Author
-
Przepiorka D, LeMaistre CF, Huh YO, Luna M, Saria EA, Brown CT, and Champlin RE
- Subjects
- Acute Disease, Adult, Antibodies, Monoclonal adverse effects, CD5 Antigens immunology, Female, Humans, Immunotoxins adverse effects, Male, Middle Aged, Pilot Projects, Ricin adverse effects, T-Lymphocyte Subsets immunology, Antibodies, Monoclonal therapeutic use, Bone Marrow Transplantation methods, Graft vs Host Disease prevention & control, Immunotoxins therapeutic use, Ricin therapeutic use
- Abstract
Anti-CD5 ricin A chain immunoconjugate (XZ-CD5) is an immunotoxin that inhibits proliferative and cytotoxic responses to alloantigen in vitro and has activity in the treatment of acute graft-vs.-host disease (GVHD). To determine if XZ-CD5 could be used to prevent acute GVHD, 11 adult recipients of HLA-identical allogeneic marrow received XZ-CD5 0.1 mg kg-1 day-1 intravenously with high-dose methyl-prednisolone for 10, 14 or 17 doses early post-transplant. Six additional patients received 17 doses of XZ-CD5 and cyclosporine (CSA). All patients engrafted. Severe capillary leak syndrome was the most common serious toxicity and occurred more frequently in patients receiving CSA (5/5 vs. 3/11, P = 0.03). All evaluable patients developed acute GVHD; 88% had grade II-IV GVHD. Flow cytometric analysis demonstrated a substantial number of circulating CD5+ and CD3+ lymphocytes during and early after administration of XZ-CD5. These results suggest that the immunotoxin did not eliminate alloreactive T cells in this setting.
- Published
- 1994