[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.204.247.205. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Article
June 3, 1988

Treatment of Steroid-Resistant Acute Graft-vs-host Disease by In Vivo Administration of an Anti—T-Cell Ricin A Chain Immunotoxin

Author Affiliations

From the Bone Marrow Transplantation Service and the Human Immunogenetics Laboratory, Memorial Sloan-Kettering Cancer Center, New York (Drs Kernan, Brochstein, Flomenberg, Dupont, and O'Reilly); and XOMA Corporation, Berkeley, Calif (Drs Byers, Scannon, and Mischak).

From the Bone Marrow Transplantation Service and the Human Immunogenetics Laboratory, Memorial Sloan-Kettering Cancer Center, New York (Drs Kernan, Brochstein, Flomenberg, Dupont, and O'Reilly); and XOMA Corporation, Berkeley, Calif (Drs Byers, Scannon, and Mischak).

JAMA. 1988;259(21):3154-3157. doi:10.1001/jama.1988.03720210044027
Abstract

The A chain of the toxin ricin has been conjugated by a disulfide bond to a murine monoclonal antibody that recognizes the CD5 (T,p67) antigen present on 95% of peripheral blood T lymphocytes. This immunotoxin was used to treat a patient with severe grade III-IV, steroid-resistant, acute graft-vs-host disease (GvHD) after an allogeneic, human leukocyte antigen—identical bone marrow transplant for acute myelogenous leukemia. Immunotoxin therapy produced a complete clinical response in the skin and gastrointestinal tract. The patient tolerated a 14-day course without symptoms or signs of toxic effects. After two days of therapy, circulating T cells could not be demonstrated by indirect immunofluorescence. After therapy, acute GvHD did not recur. However, seven months after therapy the patient demonstrated mild signs of chronic GvHD that were easily controlled with low-dose immunosuppressive therapy. These findings indicate that an anti—T-cell ricin A chain immunotoxin can be given safely for treatment of acute GvHD and may be an effective therapy for this significant posttransplant complication.

(JAMA 1988;259:3154-3157)

×