PRETREATMENT OF DONOR BONE MARROW WITH MONOCLONAL ANTIBODY OKT3 FOR PREVENTION OF ACUTE GRAFT-VERSUS-HOST DISEASE IN ALLOGENEIC HISTOCOMPATIBLE BONE-MARROW TRANSPLANTATION

Alexandra H. Filipovich, Norma K.C. Ramsay, Phyllis I. Warkentin, Philip B. Mcglave, Gideon Goldstein, John H. Kersey

Research output: Contribution to journalArticlepeer-review

98 Scopus citations

Abstract

Ten consecutive patients undergoing transplantation of bone marrow from histocompatible siblings for treatment of haematological malignancy took part in a pilot study to test the safety of invitro treatment of donor bone marrow with monoclonal antibody OKT3. Three male and seven female patients aged 7-34 years received concentrated bone-marrow buffy-coat cells which had been incubated with OKT3 before infusion. In-vitro studies confirmed that almost all immunocompetent T lymphocytes in the bone-marrow samples were coated with OKT3 at the time of infusion. In vitro, neonatal rabbit complement inhibited the proliferation of bone-marrow T lymphocytes in samples preincubated with OKT3 to less than 4% of the mitogenic responses of the untreated bone marrow. In contrast, fresh autologous complement did not effectively lyse OKT3-treated bone-marrow cells. Infusion of OKT3-treated bone marrow was safely accomplished, and engraftment was achieved in all patients (mean 23 days). Nine of ten patients survived for more than 100 days after bone-marrow transplantation, but significant acute graft-versus-host disease (GvHD) requiring treatment with steroids developed in five of the ten. This finding suggests that further modifications for bone-marrow pretreatment will be needed to achieve effective prophylaxis against acute GvHD in histocompatible bone-marrow transplantation.

Original languageEnglish (US)
Pages (from-to)1266-1269
Number of pages4
JournalThe Lancet
Volume319
Issue number8284
DOIs
StatePublished - Jun 5 1982

ASJC Scopus subject areas

  • Medicine(all)

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