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Graft-Versus-Host Disease

Therapy of steroid-refractory acute GVHD with CD52 antibody alemtuzumab is effective

Bone Marrow Transplantation volume 46, pages 143–147 (2011)Cite this article

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Abstract

The efficacy and safety of CD52 antibody alemtuzumab to treat severe acute GVHD in 18 consecutive patients refractory to standard high-dose corticosteroid therapy is reported. Patients (age range 13–68 years) had developed acute GVHD grade III and IV with gut and/or liver involvement after stem cell transplantation from family donors (n=7) or HLA-matched unrelated donors (n=11), including five donors with one or two HLA mismatches. Initially, in three patients, start doses of alemtuzumab in the range of 70–80 mg were applied and repeated after 3 to 4 weeks. Impressive responses were seen, but virus reactivation and bacterial infections were frequent. In an attempt to reduce this complication, the next nine patients received a reduced starting dose of 20–33 mg, and the last six patients received 3–13 mg repeated every 2–3 weeks. Seventeen of 18 patients responded to alemtuzumab, six patients are alive with a median follow-up of 108 weeks. Chronic GVHD was observed frequently. Although pronounced lymphocyte depletion requiring close monitoring for signs of infections seems inevitable for efficacy, alemtuzumab given in moderate doses has a substantial activity not only in intestinal but also in severe acute GVHD of the liver.

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Authors and Affiliations

  1. Division for Stem Cell Transplantation and Immunotherapy, Second Department of Medicine, Kiel, Germany

    N Schub, A Günther, C Ehlert, M Gramatzki & R Repp

  2. Department of Paediatrics, University of Kiel, Kiel, Germany

    A Schrauder & A Claviez

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  1. N Schub
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  2. A Günther
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Correspondence to M Gramatzki.

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Schub, N., Günther, A., Schrauder, A. et al. Therapy of steroid-refractory acute GVHD with CD52 antibody alemtuzumab is effective. Bone Marrow Transplant 46, 143–147 (2011). https://doi.org/10.1038/bmt.2010.68

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