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Observations on the effect of chimeric anti-CD4 monoclonal antibody in
patients with mycosis fungoides
SJ Knox, R Levy, S Hodgkinson, R Bell, S Brown, GS Wood, R Hoppe, EA Abel, L Steinman and RG Berger
Department of Radiation Oncology, Stanford University School of Medicine,
CA 94305.
Chimeric (murine/human) anti-CD4 monoclonal antibody was infused into seven
patients with mycosis fungoides. Successive patients received doses of 10,
20, 40, and 80 mg of antibody twice a week for 3 consecutive weeks. All
patients had some clinical improvement, but responses were of relatively
short duration. Serum levels of chimeric antibody varied as a function of
dose. At the 80-mg dose level, antibody was readily observed in biopsied
skin lesions. Although there was coating by antibody of most CD4 positive
cells in the blood, there was no significant depletion of CD4 positive
cells. Low-level antibody responses against the mouse Ig variable region
and human Ig allotypic constant region determinants were observed in
several patients, but none were of clinical significance. All but two
patients made primary antibody and T-cell proliferative responses to a
simultaneously administered foreign protein test antigen. However, there
was marked suppression of the mixed lymphocyte reaction. We conclude that
at the dose levels studied, a chimeric anti-CD4 monoclonal antibody (1) had
some clinical efficacy against mycosis fungoides; (2) was well tolerated;
(3) had a low level of immunogenicity; (4) had immediate immunosuppressive
effects; and (5) did not induce tolerance to a co- injected antigen.
Volume 77,
Issue 1,
pp. 20-30,
01/01/1991
Copyright © 1991 by The American Society of Hematology
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