Application of ricin-immunotoxin mediated T cell depletion to allogeneic hematopoietic stem cell transplantation.
- Author:
Yue-Yun LAI
1
;
Nai-Lan GUO
;
Xiao-Jun HUANG
;
Lan-Ping XU
;
Huan CHEN
;
Su-Qin WANG
;
Hai-Yin ZHENG
;
Yan LI
;
Bei-Fen SHEN
;
Dao-Pei LU
Author Information
1. Institute of Hematology, People's Hospital, Peking University, Beijing 100044, China. laiyueyun1008@yahoo.com.cn
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Child;
Female;
Graft vs Host Disease;
epidemiology;
Hematopoiesis;
Hematopoietic Stem Cell Transplantation;
mortality;
Humans;
Immunotoxins;
pharmacology;
Lymphocyte Depletion;
methods;
Male;
Ricin;
pharmacology;
T-Lymphocytes;
drug effects;
Transplantation, Homologous
- From:
Journal of Experimental Hematology
2004;12(3):270-273
- CountryChina
- Language:Chinese
-
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.
