Clinical Experience with Antilymphocyte Serum

Abstract

Many different antilymphocytic antisera have been used clinically, and the properties of any particular type of ALS are not necessarily identical to those of any other type. Nevertheless, it is possible to draw certain general conclusions about the effects of ALS in human subjects. ALS administration has often been shown to reduce the number of circulating E-rosette-positive lymphocytes, although the precise mechanisms by which this reduction occurs are not known. Using a combined technique of E-rosette formation and immunofluorescence, heterologous immunoglobulin has been demonstrated on T and non-T lymphocytes from patients receiving non-selective ALS. Fifteen years' experience has failed to provide convincing support for the view that ALS (including immunoglobulin prepared from the whole antiserum) prolongs human renal allograft survival. It is not yet known whether ALS is a useful immunosuppressive agent in cardiac transplantation. One observation of possible clinical interest is that bone marrow regeneration has occurred in a number of patients with aplastic anemia who have been treated with ALS. No satisfactory method has been developed for monitoring the dose of ALS in human subjects. Appropriate studies may determine whether monoclonal antilymphocytic antibodies are clinically useful, for example in prolonging the survival of transplanted organs, in preventing or treating graft-versus-host disease, or in treating lymphoma, leukemia, or aplastic anemia.

Clinical pilot study of a cytotoxic antiserum in myeloblastic leukemia

“…based on 1) the failure of a smaller dose to deplete circulating human lymphocytes by complement-mediated lysis, in a previous study [12], and 2) the similar susceptibility of human lymphocytes and leukemic myeloblasts to lysis by ALG in vitro [9]. The fact that circulating myeloblasts were only transiently depleted suggests that these cells were lysed in the blood by ALG, and then replaced by further myeloblasts from the marrow.…”

“…In addition, the concentration of horse Ig was measured in patients' sera, and the sera were examined for lymphocytotoxic antibody; the results of these assays are discussed elsewhere [9].…”

Analysis of in situ Inflammation of Allogeneic Canine Kidney Grafts under Antilymphocyte Globulin Treatment

“…In former experiments cell fluctuations due do antilymphocytic antibodies [12,13,17,24] during the posttransplant period were exclusively investigated in the peripheral blood. These observations gave no insight into the in situ events [28].…”