Serotherapy and Bone Marrow Transplantation
Within the human hematopoietic system, monoclonal antibodies have been used to identify a large number of surface antigens expressed by both normal and malignant cells, and in many instances it has now been possible to ascribe specific functions to individual cell surface molecules. Since monoclonal antibodies can be produced in large quantities and can be easily purified, it has also been possible to explore the potential therapeutic applications of these unique reagents. As a result, several different antibodies have been used in serotherapy trials in patients with refractory leukemia or lymphoma1–5 and in several solid tumors.6 In each of these studies, antibodies have been infused, with the hopes that antibody-bound tumor cells would subsequently be eliminated by natural effector mechanisms. In addition, monoclonal antibodies have also been utilized under more controlled circumstances in vitro in order to deplete specific target cells from bone marrow prior to either autologous7 or allogeneic marrow transplantation.8 In order to demonstrate the potential utility of these reagents, this chapter will focus on the specific clinical applications of monoclonal antibodies in patients with acute lymphoblastic leukemia (ALL). Although other clinical situations and other monoclonal antibodies with different specificity will undoubtedly present unique problems, much of the information gained in patients with ALL will be applicable to other leukemias and lymphomas and, to a lesser extent, to solid tumors as well.
KeywordsTotal Body Irradiation Autologous Bone Marrow Transplantation Residual Tumor Cell Allogeneic Marrow Marrow Harvest
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