ALS in bone marrow disease and bone marrow transplantation

ALS is widely used in the treatment of bone marrow disorders, particularly severe aplastic anemia. When bone marrow transplantation is not possible, ATG represents the second-best therapeutic alternative in aplastic anemia. It has also been used together with bone marrow transplantation and with good results.

The graft-versus-host reaction is a persistent problem in bone marrow transplantation. The removal of mature T cells and T cell precursors with different lymphocyte-specific antibodies has been a way of preventing it. There are, however, studies that claim that the removal of T cells from bone marrow before transplantation does not improve survival rates, and in fact can cause a higher frequency of graft failure.

An antigen on T lymphocytes which is a very good target for cell lysis is the CDw52 antigen. mAbs to this antigen, prepared in the rat (CAMPATH-1), have been used successfully to deplete donor bone marrow of T lymphocytes. The variants CAMPATH-1G (IgG2b) and CAMPATH-1 M (IgM) exist, as well as the humanized CAMPATH-1 H (human IgGl).

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