title: OKT3 incubation of donor marrow for prophylaxis of acute graft-vs.-host disease (GvHD) in allogeneic bone marrow transplantation.
abstract: Following allogeneic (matched or minor mismatched) bone marrow transplantation with marrow incubated with OKT3, 17 patients have been observed for at least 60 days for the development of acute graft-vs.-host disease. One milligram of the monoclonal (murine) antibody OKT3 was incubated with the donor marrow for one hr at room temperature prior to infusion. It was anticipated that coated/opsonized immune competent T lymphocytes would subsequently be phagocytosed by the recipient reticulo-endothelial system. Three of 17 patients developed Grade II or greater acute graft-vs.-host disease. In two, this proved fatal when complicated by cytomegalovirus infection. Eleven patients showed no evidence of acute graft-vs.-host disease and three had transient limited skin rashes (Grade I graft-vs.-host disease). Opsonization of T lymphocytes has reduced the incidence of severe acute graft-vs.-host disease in this unit from 79% (historical group) to 18% when added to prophylactic methotrexate given according to the Seattle protocol.
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001853:Bone Marrow / Q000276:immunology; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000209:etiology; D005260:Female; D006087:Graft vs Host Reaction / Q000187:drug effects; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D013601:T-Lymphocytes
chemical_list: D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D008775:Methylprednisolone