Pharmacokinetics and clinical activity of very low-dose alemtuzumab in transplantation for acute leukemia
Autor: | Marina Karakantza, Markos Marangos, Maria Themeli, Maria Liga, Alexandros Spyridonidis, E Triantafyllou, N. Zoumbos |
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Přispěvatelé: | VU University medical center |
Jazyk: | angličtina |
Rok vydání: | 2011 |
Předmět: |
Adult
Male medicine.medical_specialty Allogeneic transplantation Platelet Engraftment Adolescent medicine.medical_treatment GVHD Antineoplastic Agents donor lymphocyte infusion Hematopoietic stem cell transplantation Antibodies Monoclonal Humanized Gastroenterology Donor lymphocyte infusion Young Adult Internal medicine medicine alemtuzumab Humans Prospective Studies Aged Transplantation Acute leukemia Leukemia allogeneic hematopoietic cell transplantation business.industry Hematopoietic Stem Cell Transplantation Hematology Middle Aged medicine.disease Combined Modality Therapy Surgery surgical procedures operative Acute Disease Alemtuzumab Female Original Article business pharmacokinetics medicine.drug |
Zdroj: | Spyridonidis, A, Liga, M, Triantafyllou, E, Themeli, M, Marangos, M, Karakantza, M & Zoumbos, N 2011, ' Pharmacokinetics and clinical activity of very low-dose alemtuzumab in transplantation for acute leukemia ', Bone Marrow Transplantation, vol. 46, no. 10, pp. 1363-1368 . https://doi.org/10.1038/bmt.2010.308 Bone Marrow Transplantation, 46(10), 1363-1368. Nature Publishing Group Bone Marrow Transplantation |
ISSN: | 0268-3369 |
Popis: | The optimal dose of in vivo-administrated alemtuzumab in the allogeneic transplantation setting has not been defined. We report our experience on 37 patients with high-risk diseases, mainly acute leukemia (AML 23, ALL 10 patients), who underwent sibling (49%) or unrelated (51%) PBSCT (35 patients), and received a total dose of only 10-20 mg Campath-1H as part of the conditioning, and post-transplant CYA without MTX. The neutrophil and especially the platelet engraftment were rapid. There were only two grade III-IV acute GvHD cases, which occurred in unrelated transplants in the Campath-10 cohort. Chronic GvHD developed in six cases (17%) and was limited to skin in five of them. After a median follow-up of 371 days (59-1191), 70% patients are alive and in CR (Karnofsky 100%), and 11 died (TRM n=6, relapse n=5). From the five patients relapsed, three were at advanced stage at transplant and four underwent sibling HCT with the higher (20 mg) alemtuzumab dose. With the 10 mg alemtuzumab schedule (5 mg/day at days -2 and -1) we achieve at day of transplantation low but still lymphotoxic alemtuzumab serum concentrations (176 ng/mL), whereas levels declined fast thereafter, and at engraftment nearly no Campath antibody remained in the patient's serum. |
Databáze: | OpenAIRE |
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