title: [Application of ricin-immunotoxin mediated T cell depletion to allogeneic hematopoietic stem cell transplantation].
abstract: This study was aimed to investigate the clinical outcome of ricin-immunotoxin mediated T cell partially depleted HLA/MLC mismatched allogeneic hematopoietic stem cell transplantation. 13 patients with hematological malignancies were treated by ricin-immunotoxin mediated T cell partially depleted allogeneic hematopoietic stem cell transplantations from HLA/MLC mismatched donors, including 6 cases of CML in CP(1), 1 case of ALL in CR(1), 1 case of ALL in CR(2), 1 case of ALL in relapse, 2 cases of AML in CR(1), 1 case of AML in CR(2), 1 case of MDS-RAEBT-AML (M(4)) in CR(1). The results showed that 8 cases were engrafted successfully, 2 cases of them developed grade II acute GVHD and 2 cases developed grade III-IV acute GVHD. Within following-up of 8 - 90 months, 2 patients who experienced grade III-IV acute GVHD died early after transplantation; 1 patient died of late onset of infection; the other 5 patients survived free from diseases. After failure at first infusion, 4 patients were given reinfusion of peripheral blood hematopoietic stem cells from the same donor. 3 out of 4 cases failed to engraft and only one patient got engraftment but died of related complications of transplantation. One patient was performed a second transplantation from a syngeneic donor and survive free of disease until now. In conclusion, T cell partially depleted HLA/MLC mismatched allogeneic hematopoietic stem cell transplantation by ricin-immunotoxin decreases the occurrence of severe acute GVHD but with high risk of rejection, which clinical outcome still needs further evaluation.
authors.affiliation: Institute of Hematology, People's Hospital, Peking University, Beijing 100044, China. laiyueyun1008@yahoo.com.cn
authors.forename: Yue-Yun
authors.initials: YY
authors.lastname: Lai
authors.forename: Nai-Lan
authors.initials: NL
authors.lastname: Guo
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Huang
authors.forename: Lan-Ping
authors.initials: LP
authors.lastname: Xu
authors.forename: Huan
authors.initials: H
authors.lastname: Chen
authors.forename: Su-Qin
authors.initials: SQ
authors.lastname: Wang
authors.forename: Hai-Yin
authors.initials: HY
authors.lastname: Zheng
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Bei-Fen
authors.initials: BF
authors.lastname: Shen
authors.forename: Dao-Pei
authors.initials: DP
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006801:Humans; D000922:Immunotoxins / Q000494:pharmacology*; D008212:Lymphocyte Depletion / Q000379:methods*; D008297:Male; D012276:Ricin / Q000494:pharmacology*; D013601:T-Lymphocytes / Q000187:drug effects*; D014184:Transplantation, Homologous
chemical_list: D000922:Immunotoxins; D012276:Ricin