Alemtuzumab for the treatment of steroid-refractory acute graft-versus-host disease - PubMed (original) (raw)
Clinical Trial
Alemtuzumab for the treatment of steroid-refractory acute graft-versus-host disease
David Gómez-Almaguer et al. Biol Blood Marrow Transplant. 2008 Jan.
Free article
Abstract
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.
Similar articles
- Therapy of steroid-refractory acute GVHD with CD52 antibody alemtuzumab is effective.
Schub N, Günther A, Schrauder A, Claviez A, Ehlert C, Gramatzki M, Repp R. Schub N, et al. Bone Marrow Transplant. 2011 Jan;46(1):143-7. doi: 10.1038/bmt.2010.68. Epub 2010 Mar 29. Bone Marrow Transplant. 2011. PMID: 20348971 Clinical Trial. - Alemtuzumab as treatment of steroid-refractory acute graft-versus-host disease: results of a phase II study.
Martínez C, Solano C, Ferrá C, Sampol A, Valcárcel D, Pérez-Simón JA; Spanish Group for Stem Cell Transplantation (Grupo Español de Trasplante Hemopoyético y Terapia Celular). Martínez C, et al. Biol Blood Marrow Transplant. 2009 May;15(5):639-42. doi: 10.1016/j.bbmt.2009.01.014. Epub 2009 Mar 9. Biol Blood Marrow Transplant. 2009. PMID: 19361757 Clinical Trial. - Activity of alemtuzumab in patients with CD52-positive acute leukemia.
Tibes R, Keating MJ, Ferrajoli A, Wierda W, Ravandi F, Garcia-Manero G, O'Brien S, Cortes J, Verstovsek S, Browning ML, Faderl S. Tibes R, et al. Cancer. 2006 Jun 15;106(12):2645-51. doi: 10.1002/cncr.21901. Cancer. 2006. PMID: 16688777 Clinical Trial. - Alemtuzumab (Campath-1H) in the treatment of chronic lymphocytic leukemia.
Alinari L, Lapalombella R, Andritsos L, Baiocchi RA, Lin TS, Byrd JC. Alinari L, et al. Oncogene. 2007 May 28;26(25):3644-53. doi: 10.1038/sj.onc.1210380. Oncogene. 2007. PMID: 17530018 Review. - Alemtuzumab in solid organ transplantation and in composite tissue allotransplantation.
Weissenbacher A, Boesmueller C, Brandacher G, Oellinger R, Pratschke J, Schneeberger S. Weissenbacher A, et al. Immunotherapy. 2010 Nov;2(6):783-90. doi: 10.2217/imt.10.68. Immunotherapy. 2010. PMID: 21091110 Review.
Cited by
- Treatment of steroid-refractory graft versus host disease in children.
Gottardi F, Leardini D, Muratore E, Baccelli F, Cerasi S, Venturelli F, Zanaroli A, Belotti T, Prete A, Masetti R. Gottardi F, et al. Front Transplant. 2023 Sep 15;2:1251112. doi: 10.3389/frtra.2023.1251112. eCollection 2023. Front Transplant. 2023. PMID: 38993897 Free PMC article. Review. - Alemtuzumab treatment for steroid-refractory acute graft-versus-host disease leads to severe immunosuppression but not to relapse of malignant disease.
Philippen L, Schub N, Günther A, Cario G, Schrappe M, Repp R, Gramatzki M. Philippen L, et al. Bone Marrow Transplant. 2024 Jan;59(1):153-155. doi: 10.1038/s41409-023-02144-8. Epub 2023 Nov 6. Bone Marrow Transplant. 2024. PMID: 37932418 Free PMC article. No abstract available. - Novel therapies for graft versus host disease with a focus on cell therapies.
Zeiser R, Ringden O, Sadeghi B, Gonen-Yaacovi G, Segurado OG. Zeiser R, et al. Front Immunol. 2023 Oct 5;14:1241068. doi: 10.3389/fimmu.2023.1241068. eCollection 2023. Front Immunol. 2023. PMID: 37868964 Free PMC article. Review. - Understanding and treatment of cutaneous graft-versus-host-disease.
Hong J, Fraebel J, Yang Y, Tkacyk E, Kitko C, Kim TK. Hong J, et al. Bone Marrow Transplant. 2023 Dec;58(12):1298-1313. doi: 10.1038/s41409-023-02109-x. Epub 2023 Sep 20. Bone Marrow Transplant. 2023. PMID: 37730800 Review. - Efficacy and safety of mesenchymal stem cells treatment for multidrug-resistant graft-_versus_-host disease after haploidentical allogeneic hematopoietic stem cell transplantation.
Shen MZ, Liu XX, Qiu ZY, Xu LP, Zhang XH, Wang Y, Yan CH, Chen H, Chen YH, Han W, Wang FR, Wang JZ, Liu SN, Liu KY, Huang XJ, Mo XD. Shen MZ, et al. Ther Adv Hematol. 2022 Jan 20;13:20406207211072838. doi: 10.1177/20406207211072838. eCollection 2022. Ther Adv Hematol. 2022. PMID: 35096361 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources