R A Brodsky1, A K Fuller, L E Ratner, M S Leffell, R J Jones. 1. Johns Hopkins Oncology Center, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA. rbrodsky@jhmi.edu
Abstract
BACKGROUND: Alloimmunization is a major problem for patients being considered for solid organ transplantation and in patients who require blood transfusion support. We previously demonstrated that high-dose cyclophosphamide (200 mg/kg) without hematopoietic stem cell transplantation leads to durable complete remissions in aplastic anemia and other autoimmune disorders. We now examine the ability of high-dose cyclophosphamide to eliminate alloreactivity. METHODS: IgG-specific antibodies to HLA class I were assayed using enzyme-linked immunosorbent assays in 18 consecutive patients with severe aplastic anemia before and after treatment with high-dose cyclophosphamide. RESULTS: Anti-HLA antibodies were detected before or shortly after therapy in 5 of the 18 patients studied. Complete remission of aplastic anemia was achieved in four of these five patients. High-dose cyclophosphamide markedly reduced anti-HLA antibody titers in these four patients; they were completely eradicated in three patients. Only one patient did not achieve significant reduction in the alloantibody titer after high-dose cyclophosphamide. CONCLUSIONS: High-dose cyclophosphamide without stem cell transplantation can eradicate HLA-specific alloantibody.
BACKGROUND: Alloimmunization is a major problem for patients being considered for solid organ transplantation and in patients who require blood transfusion support. We previously demonstrated that high-dose cyclophosphamide (200 mg/kg) without hematopoietic stem cell transplantation leads to durable complete remissions in aplastic anemia and other autoimmune disorders. We now examine the ability of high-dose cyclophosphamide to eliminate alloreactivity. METHODS: IgG-specific antibodies to HLA class I were assayed using enzyme-linked immunosorbent assays in 18 consecutive patients with severe aplastic anemia before and after treatment with high-dose cyclophosphamide. RESULTS: Anti-HLA antibodies were detected before or shortly after therapy in 5 of the 18 patients studied. Complete remission of aplastic anemia was achieved in four of these five patients. High-dose cyclophosphamide markedly reduced anti-HLA antibody titers in these four patients; they were completely eradicated in three patients. Only one patient did not achieve significant reduction in the alloantibody titer after high-dose cyclophosphamide. CONCLUSIONS: High-dose cyclophosphamide without stem cell transplantation can eradicate HLA-specific alloantibody.
Authors: Hong Xu; Paula M Chilton; Michael K Tanner; Yiming Huang; Carrie L Schanie; Mariano Dy-Liacco; Jun Yan; Suzanne T Ildstad Journal: Blood Date: 2006-08-03 Impact factor: 22.113
Authors: Douglas E Gladstone; Andrea A Zachary; Ephraim J Fuchs; Leo Luznik; Yvette L Kasamon; Karen E King; Robert A Brodsky; Richard J Jones; Mary S Leffell Journal: Biol Blood Marrow Transplant Date: 2013-01-22 Impact factor: 5.742
Authors: R A Brodsky; L Luznik; J Bolaños-Meade; M S Leffell; R J Jones; E J Fuchs Journal: Bone Marrow Transplant Date: 2008-07-14 Impact factor: 5.483