Treatment of steroid-resistant acute graft-vs-host disease by in vivo administration of an anti—T-cell ricin a chain immunotoxin Journal Article

  

Authors:	Kernan, N. A.; Byers, V.; Scannon, P. J.; Mischak, R. P.; Brochstein, J.; Flomenberg, N.; Dupont, B.; O’Reilly, R. J.
Article Title:	Treatment of steroid-resistant acute graft-vs-host disease by in vivo administration of an anti—T-cell ricin a chain immunotoxin
Abstract:	The A chain of the toxin ricin has been conjugated by a disulfide bond to a murine monoclonal antibody that recognizes the CD5 (T,p67) antigen present on 95% of peripheral blood T lymphocytes. This immunotoxin was used to treat a patient with severe grade III-IV, steroid-resistant, acute graft-vs-host disease (GvHD) after an allogeneic, human leukocyte antigen—identical bone marrow transplant for acute myelogenous leukemia. Immunotoxin therapy produced a complete clinical response in the skin and gastrointestinal tract. The patient tolerated a 14-day course without symptoms or signs of toxic effects. After two days of therapy, circulating T cells could not be demonstrated by indirect immunofluorescence. After therapy, acute GvHD did not recur. However, seven months after therapy the patient demonstrated mild signs of chronic GvHD that were easily controlled with low-dose immunosuppressive therapy. These findings indicate that an anti—T-cell ricin A chain immunotoxin can be given safely for treatment of acute GvHD and may be an effective therapy for this significant posttransplant complication. © 1988, American Medical Association. All rights reserved.
Keywords:	child; school child; acute granulocytic leukemia; case report; methotrexate; t-lymphocytes; drug resistance; fluorescent antibody technique; antibodies, monoclonal; graft versus host reaction; methylprednisolone; immunosuppressive treatment; bone marrow transplantation; graft vs host disease; intravenous drug administration; acute disease; antigen-antibody reactions; immunotoxins; leukemia, myelocytic, acute; ricin; ricin a; human; female; priority journal; support, non-u.s. gov't; support, u.s. gov't, p.h.s.
Journal Title:	JAMA - Journal of the American Medical Association
Volume:	259
Issue:	21
ISSN:	0098-7484
Publisher:	American Medical Association
Date Published:	1988-06-03
Start Page:	3154
End Page:	3157
Language:	English
DOI:	10.1001/jama.1988.03720210044027
PUBMED:	3285046
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0023919604&doi=10.1001%2fjama.1988.03720210044027&partnerID=40&md5=feda3fbcd5bb2eb978c3732d98940fa8
Notes:	Article -- Source: Scopus

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