title: Anti-CD25 monoclonal antibody (basiliximab) for prevention of graft-versus-host disease after haploidentical bone marrow transplantation for hematological malignancies.
abstract: Haploidentical donors are available for most patients who need allografts but do not have matched donors. However, GVHD, rejection, delayed immune reconstitution, and infections have been significant barriers. We designed a haploidentical BMT protocol focusing on prevention of GVHD and rejection. A total of 53 leukemic patients underwent haploidentical G-CSF-primed BMT without ex vivo T-cell depletion. GVHD prophylaxis consisted of antithymocyte globulin, cyclosporine, methotrexate, and mycophenolate mofetil. In all, 38 patients (the CD25 group) received additional anti-CD25 monoclonal antibody basiliximab. The results were compared to 15 patients who did not receive basiliximab. All patients achieved trilineage engraftment with full-donor chimerism. The incidence of acute II-IV GVHD was 11% in the CD25 group vs 33% in the control group (P=0.046). The overall incidence of extensive chronic GVHD was 15%. T, B, and NK cells recovered within 12 months post transplant. The disease-free survival at 2 years was 53% with a median follow-up of 31 months. In conclusion, G-CSF primed haploidentical BMT along with sequential immunosuppressive agents as described here deserves further study.
authors.affiliation: Research Institution of Hematology, and Air Force General Hospital, Air Force of China, PLA, Beijing, PR China.
authors.forename: S-Q
authors.initials: SQ
authors.lastname: Ji
authors.forename: H-R
authors.initials: HR
authors.lastname: Chen
authors.forename: H-M
authors.initials: HM
authors.lastname: Yan
authors.forename: H-X
authors.initials: HX
authors.lastname: Wang
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.forename: P-y
authors.initials: PY
authors.lastname: Zhu
authors.forename: M-h
authors.initials: MH
authors.lastname: Xiao
authors.forename: C-Q
authors.initials: CQ
authors.lastname: Xun
mesh_terms: D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D000077552:Basiliximab; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000379:methods; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000517:prevention & control*; D006239:Haplotypes; D019337:Hematologic Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy; D006801:Humans; D007107:Immune System / Q000166:cytology; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D015994:Incidence; D008297:Male; D011292:Premedication; D015375:Receptors, Interleukin-2 / Q000276:immunology; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D016019:Survival Analysis
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D015375:Receptors, Interleukin-2; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab