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Identifier

000338872

Title

Μελέτη της αποτελεσματικότητας του αντι-TNFa χιμαιρικού αντισώματος cA2 (Infliximab) στη θεραπεία ασθενών με μυελοδυσπλαστικά σύνδρομα

Alternative Title

Study of the effect of anti-TNFa chimeric monoclonal antibody cA2 (Infliximab) therapy on hematopoiesis of patients with myelodysplastic syndromes

Author

Μπουλά, Άννα

Thesis advisor

Παπαδάκη, Ελένη

Reviewer

Ηλιόπουλος, Γεώργιος
Κολιός, Γεώργιος
Σαμώνης, Γεώργιος
Μπούμπας, Δημήτριος
Κουρούμαλης, Ηλίας
Ηλιόπουλος, Αριστείδης
Αλεξανδράκης, Μιχάλης

Abstract

Tumor necrosis factor-a (TNF-a) plays a prominent role in the pathophysiology of myelodysplastic syndromes (MDS). The aim of this study was to explore the biological and immunoregulatory effect of the treatment with the anti-tumor necrosis factor-a monoclonal antibody cA2 on bone marrow (BM) progenitor/precursor and stromal cells and lymphocyte subsets, as well as the clinical response in MDS patients. Ten low, intermediate-1, -2 risk MDS patients received i.v. cA2 (3 mg/kg) at weeks 0, 2, 6, and 12. The number, survival, and clonogenic potential of BM progenitor/precursor cells, the hematopoiesis-supporting capacity of BM stromal cells, and the lymphocyte activation status were investigated in the patients at baseline and following treatment using flow cytometry, clonogenic assays, and long-term BM cultures (LTBMC). Clinical response was evaluated according to standardized criteria. cA2 administration reduced the proportion of apoptotic and Fas+ cells in the CD34+ cell compartment (P = 0.0215 and P = 0.0344, respectively) and increased the clonogenic potential of BM mononuclear and CD34+ cells (P = 0.0399 and P = 0.0304, respectively) compared with baseline. The antibody reduced tumor necrosis factor-a levels in LTBMC supernatants (P = 0.0043) and significantly improved the hematopoiesis-supporting capacity of LTBMC adherent cells. The proportion of activated peripheral blood and BM T-lymphocytes decreased significantly after treatment, suggesting an immunomodulatory effect of cA2. Two patients displayed minor hematologic responses whereas the remaining patients displayed stable disease with no disease progression. The encouraging biological insights from cA2 administration may be useful in conducting further clinical trials using cA2 for selected MDS patients, particularly those with evidence of immune-mediated inhibition of hematopoiesis.

Language

Greek

Subject

Myelodysplastic Syndromes

Issue date

2006-12-20

Collection

School/Department--School of Medicine--Department of Medicine--Doctoral theses

Type of Work--Doctoral theses

Permanent Link

https://elocus.lib.uoc.gr//dlib/c/c/5/metadata-dlib-9b64a2ed8cf1a55c3162260ed514794c_1232441915.tkl