Subject(s)
Diphtheria Toxin/therapeutic use , Immunotoxins/therapeutic use , Interleukin-2/therapeutic use , Lymphoma/therapy , Recombinant Fusion Proteins/therapeutic use , Adult , Aged , Aged, 80 and over , Diphtheria Toxin/adverse effects , Female , Humans , Immunotoxins/adverse effects , Interleukin-2/adverse effects , Interleukin-2/physiology , Male , Middle Aged , Receptors, Interleukin-2/physiology , Recombinant Fusion Proteins/adverse effectsABSTRACT
Cytomegalovirus (CMV) infection is one of the most common causes of morbidity and mortality after allogeneic marrow transplantation. We studied 14 consecutive CMV-seropositive patients adding ganciclovir (2.5 mg/kg i.v. every 8 hours for 7 days prior to transplant and 6 mg/kg three times a week after neutrophils became greater than 0.5 x 10(9)/l and the patients were platelet transfusion-independent until d 70) to our previous prophylaxis regimen which consisted of intravenous immunoglobulin and acyclovir. The result was compared with 30 consecutive patients whom we studied with our previous regimen. The addition of ganciclovir did not cause any extra toxicities. The incidence of interstitial pneumonitis and cumulative probability of CMV excretion in the first 100 d post-transplantation was significantly reduced (p = 0.038 and p = 0.035 respectively). The result shows that addition of ganciclovir significantly decreased the incidence of CMV infection in the early post-transplantation period.
Subject(s)
Bone Marrow Transplantation , Cytomegalovirus Infections/prevention & control , Ganciclovir/therapeutic use , Adolescent , Adult , Female , Humans , Male , Middle Aged , Pulmonary Fibrosis/prevention & control , Transplantation, HomologousABSTRACT
In DAB486IL-2 the receptor-binding domain of native diphtheria toxin is replaced by human IL-2 sequences. This recombinant fusion protein is selectively cytotoxic for cells bearing high-affinity IL-2 receptors--eg, leukaemic cells. A patient with chronic lymphocytic leukaemia who did not respond to gamma interferon and conventional antileukaemic drugs has responded to DAB486IL-2.
Subject(s)
Diphtheria Toxin/therapeutic use , Interleukin-2/therapeutic use , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Receptors, Interleukin-2/drug effects , Diphtheria Toxin/blood , Drug Administration Schedule , Humans , Injections, Intravenous , Interleukin-2/blood , Leukemia, Lymphocytic, Chronic, B-Cell/blood , Leukocyte Count/drug effects , Male , Middle Aged , Recombinant Fusion Proteins/blood , Recombinant Fusion Proteins/therapeutic use , T-Lymphocytes/drug effectsABSTRACT
Twenty-four patients were given the combination of methylprednisolone 100 mg i.v. on day 0, cyclosporine 2 mg/kg i.v. every 12 h starting on day -3 and methotrexate 5 mg/m2 on days 1, 3, and 6, then 10 mg/m2 on days 11 and 18 after allogeneic bone marrow transplantation for hematological malignancies for the prophylaxis of acute graft-versus-host disease. (GVHD). Methylprednisolone was given prior to the marrow infusion for its lympholytic effect. The methotrexate dose on days 1, 3, and 6 was half of that given in other studies to decrease the early toxicities. The outcome of this group is compared with patients transplanted before 1988 and given methotrexate alone, methotrexate with prednisone, or cyclosporine alone. There is no difference in relapse and survival between the groups at this time. The rate of engraftment and incidence of mucositis with the combination is not significantly different from the cyclosporine group. No patient developed greater than grade II acute GVHD with the combination. The probability of grade II or higher acute GVHD with the combination (14%) is significantly less than methotrexate, with or without prednisone or cyclosporine alone.