Nonmyeloablative haploidentical stem-cell transplantation using anti-CD2 monoclonal antibody (MEDI-507)-based conditioning for refractory hematologic malignancies

Transplantation. 2003 May 27;75(10):1748-51. doi: 10.1097/01.TP.0000064211.23536.AD.

Abstract

We initiated a clinical trial of nonmyeloablative haploidentical stem-cell transplantation (SCT) using MEDI-507, an immunoglobulin-G1 monoclonal anti-CD2 antibody. The trial was based on a preclinical major histocompatibility complex-mismatched bone marrow transplant model in which graft-versus-host disease (GVHD) was prevented and mixed chimerism as a platform for adoptive cellular immunotherapy was reliably induced. Twelve patients (three cohorts of four patients each) received cyclophosphamide, MEDI-507, and haploidentical unmanipulated bone marrow (n=8) or ex vivo T-cell-depleted peripheral blood stem cells (n=4) for chemorefractory hematologic malignancy. A two-dose regimen and schedule modifications of MEDI-507 were undertaken because of graft loss in the first cohort of four patients and GVHD in the second cohort. With ex vivo T-cell-depleted peripheral blood SCT, mixed chimerism occurred in all four patients without GVHD. Two patients, however, subsequently lost their grafts. Nonmyeloablative preparative therapy with MEDI-507 and haploidentical SCT have led to the reliable induction of at least transient mixed chimerism as a potential platform for adoptive cellular immunotherapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / therapeutic use*
  • Bone Marrow / physiology
  • Bone Marrow Transplantation
  • CD2 Antigens / immunology*
  • Cohort Studies
  • Cyclophosphamide / therapeutic use
  • Drug Administration Schedule
  • Graft Rejection / epidemiology
  • Haploidy
  • Hematologic Neoplasms / surgery*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Middle Aged
  • Stem Cell Transplantation*
  • Stem Cells / physiology
  • Transplantation Chimera
  • Transplantation Conditioning / methods*

Substances

  • Antibodies, Monoclonal
  • CD2 Antigens
  • Immunosuppressive Agents
  • Cyclophosphamide