A phase 2/3 multicenter randomized clinical trial of ABX-CBL versus ATG as secondary therapy for steroid-resistant acute graft-versus-host disease

  • Margaret L. MacMillan
  • , Daniel Couriel
  • , Daniel J. Weisdorf
  • , Gisela Schwab
  • , Nancy Havrilla
  • , Thomas R. Fleming
  • , Saling Huang
  • , Lorin Roskos
  • , Shimon Slavin
  • , Richard K. Shadduck
  • , John DiPersio
  • , Mary Territo
  • , Steve Pavletic
  • , Charles Linker
  • , Helen E. Heslop
  • , H. Joachim Deeg
  • , Bruce R. Blazar

Research output: Contribution to journalArticlepeer-review

84 Scopus citations

Abstract

Treatment for steroid-resistant acute graft-versus-host disease (GVHD) has had limited success. ABX-CBL is a hybridoma-generated murine IgM monoclonal antibody against the CD147 antigen, weakly expressed on human leukocytes and up-regulated on activated lymphocytes. A prospective, multicenter, open-label, randomized clinical trial comparing ABX-CBL to antithymocyte globulin (ATG) for treatment of steroid-resistant acute GVHD was conducted in 95 patients at 21 centers. Forty-eight patients received ABX-CBL daily for 14 consecutive days followed by up to 6 weeks of ABX-CBL twice weekly. Forty-seven patients received equine ATG, 30 mg/kg every other day for a total of 6 doses with additional courses as needed. By day 180, overall improvement was similar in the patients receiving ABX-CBL and in those receiving ATG (56% versus 57%, P = .91). Patient survival at 18 months was less favorable on ABX-CBL than on ATG (35% versus 45%), with the 95% confidence interval ruling out that ABX-CBL provides at least a 10.4% improvement. Data from this trial suggest that ABX-CBL does not offer an improvement over ATG in the treatment of acute steroid-resistant GVHD. This prospective, multicenter, randomized clinical trial for steroid-resistant acute GVHD serves as a model for future evaluation of new agents.

Original languageEnglish (US)
Pages (from-to)2657-2662
Number of pages6
JournalBlood
Volume109
Issue number6
DOIs
StatePublished - Mar 15 2007

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