The incidence of antibody formation to OKT3 consequent to its use in organ transplantation.
Enzyme-linked immunosorbent assays were performed on 12,133 serum samples to determine the incidence of anti-OKT3 antibody formation among transplant recipients who had received OKT3 for rejection treatment or prophylaxis. High anti-OKT3 antibody titers (> or = 1:1000) were detected in 5.8% of samples drawn 2 to 8 weeks following initiation of OKT3 therapy. The frequency of high titers differed by organ (6.9%, 2.7%, and 5.3% for kidney, heart, and liver, respectively; P < 0.001) and by sampling times (P < 0.001). The highest frequency of positive titers was obtained in samples obtained between 2 and 4 weeks following the initiation of OKT3. For all transplant recipients and for kidney recipients alone, multivariate logistic regression showed that the risk of high anti-OKT3 titers varied significantly at 2 to 4 weeks and at 4 to 6 weeks (but not at 6 to 8 weeks) with age (the youngest patients had the highest incidence, with a steady decline after age 30; P < 0.05), course of therapy (lowest frequencies followed a first course of OKT3; P < 0.001), and transplant number (lowest frequencies followed a first transplant; P < 0.01). Analyses of a set of patients on whom immunosuppressive regimen information was available indicated that prophylactic or maintenance treatment with CsA was associated with a significantly lower frequency of high-titer anti-OKT3 antibodies than was therapy without CsA (P < 0.001). In conclusion, this series provides confirming evidence that high-titer anti-OKT3 antibodies, which are of concern whenever retreatment with OKT3 is contemplated, occur in a low percentage of patients and are associated with such factors as age, previous transplantation or courses of therapy with OKT3, and treatment with CsA.
Carey
G
G
Immunobiology Business Unit, Ortho Biotech, Inc., Raritan, NJ 08869-0602, USA.
Lisi
P J
PJ
Schroeder
T J
TJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000888:Antibodies, Anti-Idiotypic / Q000096:biosynthesis*; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D004797:Enzyme-Linked Immunosorbent Assay; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D015999:Multivariate Analysis; D016853:Muromonab-CD3 / Q000276:immunology*; D016377:Organ Transplantation; D013997:Time Factors
D000888:Antibodies, Anti-Idiotypic; D016853:Muromonab-CD3; D016572:Cyclosporine