Anti-pan T lymphocyte ricin A chain immunotoxin (H65-RTA) and methylprednisolone for acute GVHD prophylaxis following allogeneic BMT from HLA-identical sibling donors.
Six patients (five children < or = 12 years old and one young adult) underwent allogeneic BMT (not T lymphocyte-depleted) from sex-matched HLA-identical siblings. GVHD prophylaxis consisted of methylprednisolone (30 mg/m2) and anti-pan T lymphocyte ricin A chain immunotoxin (H65-RTA) (0.1 mg/kg) administered daily for 12 consecutive doses. H65-RTA was initiated at day +5 (n = 4) or day +2 (n = 2). All patients engrafted. Despite receiving the planned GVHD prophylaxis, all patients developed moderate to severe acute GVHD; five patients developed Grade III/IV GVHD. Four patients died 34 to 78 days post-transplant; GVHD was a contributory cause of death in each case. H65-RTA as used in this study was ineffective for the prophylaxis of acute GVHD.
Krance
R
R
Department of Hematology/Oncology, St Jude Children's Research Hospital, Memphis, TN 38101-0318.
Heslop
H E
HE
Mahmoud
H
H
Ribeiro
R
R
Douglass
E
E
Hurwitz
C
C
Santana
V
V
Kun
L
L
Horowitz
M M
MM
Brenner
M K
MK
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000276:immunology; D002648:Child; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control*; D006680:HLA Antigens; D006801:Humans; D000922:Immunotoxins / Q000494:pharmacology*; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology*; D012276:Ricin / Q000494:pharmacology*; D013601:T-Lymphocytes / Q000276:immunology
D006680:HLA Antigens; D000922:Immunotoxins; D012276:Ricin; D008775:Methylprednisolone