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Protective Conditioning for Acute Graft-versus-Host Disease

Protective Conditioning for Acute Graft-versus-Host Disease,Robert Lowsky,Tsuyoshi Takahashi,Yin Ping Liu,Sussan Dejbakhsh-Jones,F. Carl Grumet,Judith

Protective Conditioning for Acute Graft-versus-Host Disease   (Citations: 38)
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background Conditioning with total lymphoid irradiation plus antithymocyte serum protects mice against acute graft-versus-host disease (GVHD) after hematopoietic-cell transplanta- tion. We tested this strategy in humans. methods Thirty-seven patients with lymphoid malignant diseases or acute leukemia under- went an experimental conditioning regimen with 10 doses of total lymphoid irradia- tion (80 cGy each) plus antithymocyte globulin, followed by an infusion of HLA-matched peripheral-blood mononuclear cells from related or unrelated donors who received granulocyte colony-stimulating factor. results Of the 37 transplant recipients, only 2 had acute GVHD after hematopoietic-cell trans- plantation. Potent antitumor effects in patients with lymphoid malignant diseases were shown by the change from partial to complete remission. In the transplant recip- ients who underwent conditioning with total lymphoid irradiation and antithymocyte globulin, the fraction of donor CD4+ T cells that produced interleukin-4 after in vitro stimulation increased by a factor of five, and the proliferative response to alloantigens in vitro was reduced, as compared with normal control subjects and control subjects who underwent conditioning with a single dose of total-body irradiation (200 cGy). conclusions A regimen of total lymphoid irradiation plus antithymocyte globulin decreases the in- cidence of acute GVHD and allows graft antitumor activity in patients with lymphoid malignant diseases or acute leukemia treated with hematopoietic-cell transplantation.
Published in 2010.
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