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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
12
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pubmed:dateCreated |
1992-7-9
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pubmed:abstractText |
In a multicenter pilot study, 19 patients with severe acute graft-versus-host disease (aGVHD) refractory to conventional therapy and serotherapy with a monoclonal anti-interleukin-2 receptor antibody were treated by in vivo infusion of a monoclonal anti-tumor necrosis factor alpha (TNF alpha) antibody (B-C7). Ten patients were grafted from a genotypically identical sibling, five from an HLA-mismatched family member, and four from an HLA-matched unrelated donor. Before B-C7 treatment, 15 patients had grade IV and four had grade III GVHD. In all cases, patients received cyclosporine/methotrexate as aGVHD prophylaxis. Patients were administered increasing doses of antibody (from 0.1 to 0.4 mg/kg). The antibody was infused in bolus daily for 4 days and then every other day twice (6 doses). No side effects were observed during treatment regardless of the dose level used. Changes in peripheral blood cell counts occurred in 8 of the 19 patients and appeared to be unrelated to B-C7. No truly complete response was observed; eight patients achieved a very good partial response (42.6%) and six a partial response (31.5%). The treatment was ineffective in five patients (26.4%). When present, the response occurred early (less than 3 days). In the 14 responding patients, gut lesions responded best (100%), followed by skin (85%) and liver (35.7%) lesions. In 9 of 11 evaluable patients (81%), GVHD recurred when treatment was discontinued in a median delay of 3 days (range, 2 to 120 days). All except one died from aGVHD. Two patients did not experience GVHD recurrence and are still alive 13 and 18 months post-bone marrow transplantation. This pilot study shows that a monoclonal anti-TNF alpha antibody may be of benefit to some patients with severe refractory aGVHD, but is ineffective to prevent GVHD recurrence in the majority of cases.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
AIM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Jun
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pubmed:issn |
0006-4971
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:day |
15
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pubmed:volume |
79
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pubmed:owner |
NLM
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pubmed:authorsComplete |
N
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pubmed:pagination |
3362-8
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pubmed:dateRevised |
2006-11-15
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pubmed:meshHeading |
pubmed-meshheading:1596576-Acute Disease,
pubmed-meshheading:1596576-Adolescent,
pubmed-meshheading:1596576-Adult,
pubmed-meshheading:1596576-Antibodies, Monoclonal,
pubmed-meshheading:1596576-Child,
pubmed-meshheading:1596576-Child, Preschool,
pubmed-meshheading:1596576-Female,
pubmed-meshheading:1596576-Graft vs Host Disease,
pubmed-meshheading:1596576-Humans,
pubmed-meshheading:1596576-Immunotherapy,
pubmed-meshheading:1596576-Infant,
pubmed-meshheading:1596576-Kinetics,
pubmed-meshheading:1596576-Male,
pubmed-meshheading:1596576-Recurrence,
pubmed-meshheading:1596576-Tumor Necrosis Factor-alpha
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pubmed:year |
1992
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pubmed:articleTitle |
Phase I-II trial of a monoclonal anti-tumor necrosis factor alpha antibody for the treatment of refractory severe acute graft-versus-host disease.
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pubmed:affiliation |
Bone Marrow Transplant Unit, Besançon, France.
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pubmed:publicationType |
Journal Article,
Clinical Trial,
Research Support, Non-U.S. Gov't,
Multicenter Study
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