Treatment of aGVHD with OKT3: clinical outcome and side-effects associated with release of TNF alpha

Bone Marrow Transplant. 1991 Aug;8(2):93-8.

Abstract

Monoclonal antibodies are increasingly used for treatment of acute graft-versus-host disease (aGVHD) in bone marrow transplantation. We treated seven patients with steroid resistant aGVHD with the monoclonal anti-T cell antibody OKT3. Though five patients showed improvement of aGVHD, only two became long-term survivors. OKT3 treatment was accompanied by deterioration of microangiopathy and prolonged increase of tumor-necrosis-factor alpha serum levels indicating activation of monocytes/macrophages in vivo, as this was not observed in a control group of patients receiving anti-T cell globulin. These findings may be related to immunostimulatory activity reported for OKT3 in vitro. Strategies interfering with cytokine release should improve clinical results of OKT3 treatment.

MeSH terms

  • Acute Disease
  • Adult
  • Bone Marrow Transplantation / adverse effects*
  • Bone Marrow Transplantation / immunology
  • Female
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / prevention & control
  • Graft vs Host Disease / therapy*
  • Humans
  • Immunoglobulin G / biosynthesis
  • In Vitro Techniques
  • Lymphocyte Activation
  • Male
  • Muromonab-CD3 / adverse effects
  • Muromonab-CD3 / therapeutic use*
  • Tumor Necrosis Factor-alpha / metabolism*

Substances

  • Immunoglobulin G
  • Muromonab-CD3
  • Tumor Necrosis Factor-alpha