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Blood, 15 August 2004, Vol. 104, No. 4, pp. 1224-1226.
Prepublished online as a Blood First Edition Paper on April 27, 2004; DOI 10.1182/blood-2004-01-0028.
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TRANSPLANTATION Brief report
Safety and efficacy of denileukin diftitox in patients with steroid-refractory acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation
Vincent T. Ho,
David Zahrieh,
Ephraim Hochberg,
Eileen Micale,
Jesse Levin,
Carol Reynolds,
Steve Steckel,
Corey Cutler,
David C. Fisher,
Stephanie J. Lee,
Edwin P. Alyea,
Jerome Ritz,
Robert J. Soiffer, and
Joseph H. Antin
From the Divisions of Medical Oncology and Biostatistics, Dana-Farber Cancer Institute, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Ligand Pharmaceuticals, Inc, San Diego, CA; and Harvard Medical School, Boston MA.
Denileukin diftitox (Ontak), a recombinant protein composed of human interleukin 2 (IL-2) fused to diphtheria toxin, has selective cytotoxicity against activated lymphocytes expressing the high-affinity IL-2 receptor. We conducted a phase 1 study of denileukin diftitox in 30 patients with steroid refractory acute graft-versus-host disease (GVHD). Seven patients received 9 µg/kg intravenously on days 1 and 15; 18 received 9 µg/kg intravenously on days 1, 3, 5, 15, 17, and 19; and 5 received 9 µg/kg intravenously on days 1 to 5 and 15 to 19. Hepatic transaminase elevation was the dose-limiting toxicity (DLT), and dose level 2 was the maximum tolerated dose (MTD). Overall, 71% of patients responded with complete resolution (12 of 24; 50%) or partial resolution (5 of 24; 21%) of GVHD. Eight of 24 patients (33%) are alive at 6.3 to 24.6 months (median, 7.2 months). Denileukin diftitox is tolerable and has promising activity in steroid-refractory acute GVHD. (Blood. 2004;104:1224-1226)

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