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Graft-Versus-Host Disease

Low-dose alemtuzumab (Campath®) in myeloablative allogeneic stem cell transplantation for CD52-positive malignancies: decreased incidence of acute graft-versus-host-disease with unique pharmacokinetics

Bone Marrow Transplantation volume 33, pages 833–837 (2004)Cite this article

Summary:

Alemtuzumab is effective in reducing the risk of acute graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (ASCT). Alemtuzumab may also delay immune reconstitution and reduce graft-versus-leukemia effects. The optimal dose has not been established. We investigated engraftment, acute GVHD incidence and severity, and pharmacokinetics of alemtuzumab associated with the use of low-dose alemtuzumab/cyclophosphamide/total body irradiation and ASCT for patients with aggressive CD52-positive hematologic malignancies. In all, 12 patients were treated. Alemtuzumab 10 mg daily on days −7 to −3 was given intravenously. Tacrolimus and methotrexate were used for GVHD prophylaxis. Alemtuzemab was not detected in any of the 36 sequential serum samples tested between days −1 and +21 of transplant. All patients engrafted rapidly; the median time to an absolute neutrophil count >0.5 × 109/l was 14 days (range 11–17 days), and the median time to a platelet count >20 × 109/l was 16 days (range 6–30 days). By 1 month after transplant, nine patients had 100% donor chimerism, while three had mixed donor chimerism. At 3 months, 11 had achieved 100% donor chimerism. No cases of grade III/IV acute GVHD occurred. At a median follow-up interval of 14.7 months (range 4–24), seven patients remained alive, and five remained free of disease.

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Authors and Affiliations

  1. Department of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    I F Khouri, R M Saliba, C Ippoliti, Y C Ma & R E Champlin

  2. Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    M Albitar

  3. Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    M J Keating

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  1. I F Khouri
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  2. M Albitar
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  3. R M Saliba
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  4. C Ippoliti
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  6. M J Keating
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  7. R E Champlin
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Correspondence to I F Khouri.

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Khouri, I., Albitar, M., Saliba, R. et al. Low-dose alemtuzumab (Campath®) in myeloablative allogeneic stem cell transplantation for CD52-positive malignancies: decreased incidence of acute graft-versus-host-disease with unique pharmacokinetics. Bone Marrow Transplant 33, 833–837 (2004). https://doi.org/10.1038/sj.bmt.1704435

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