PMID- 9758310
OWN - NLM
STAT- MEDLINE
DCOM- 19981209
LR  - 20071115
IS  - 0277-0008 (Print)
IS  - 0277-0008 (Linking)
VI  - 18
IP  - 5
DP  - 1998 Sep-Oct
TI  - Monoclonal antibodies in the treatment of steroid-resistant acute 
      graft-versus-host disease.
PG  - 988-1000
AB  - Acute graft-versus-host disease (GVHD) remains the major obstacle for successful 
      allogeneic bone marrow transplantation (BMT). The frequency of grade II or higher 
      acute GVHD ranges from 30-50% in human leukocyte antigen (HLA)-matched sibling 
      transplants and 50-80% in HLA-matched unrelated transplants. The mortality and 
      morbidity associated with this complication are substantial. Corticosteroid and 
      polyclonal antibodies such as antithymocyte globulin (ATG) have had little 
      success in treating the disease; however, advances have been made in hybridoma 
      technology and understanding its immunopathophysiology. Based on these new 
      insights, monoclonal antibodies, either murine or "humanized," were tested as 
      rescue treatment for acute GVHD in human trials. Complete response rates ranged 
      from 20-40%, with relapse occurring often. Side effects consisted of 
      constitutional symptoms such as fever, chills, hypotension, thrombocytopenia, and 
      leukopenia. Limitations of monoclonal antibody treatment included low response 
      rate and patient survival, high relapse rate, risk of infectious complication, 
      and leukemic relapse. Future study should focus not only on improved side effects 
      and efficacy of monoclonal antibodies but also on better patient survival.
FAU - Tse, J C
AU  - Tse JC
AD  - Department of Pharmaceutical Services, UCLA Medical Center, Los Angeles, 
      California 90095-1707, USA.
FAU - Moore, T B
AU  - Moore TB
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Pharmacotherapy
JT  - Pharmacotherapy
JID - 8111305
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Bone Marrow Transplantation/*adverse effects
MH  - Clinical Trials as Topic
MH  - Drug Resistance
MH  - Graft vs Host Disease/*therapy
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
RF  - 81
EDAT- 1998/10/03 00:00
MHDA- 1998/10/03 00:01
CRDT- 1998/10/03 00:00
PHST- 1998/10/03 00:00 [pubmed]
PHST- 1998/10/03 00:01 [medline]
PHST- 1998/10/03 00:00 [entrez]
PST - ppublish
SO  - Pharmacotherapy. 1998 Sep-Oct;18(5):988-1000.