[PAGID] Complete DiGeorge options

[Cowan, Mort]

What is the clinical experience with this kind of approach? Are you
thinking of using Daclizamab? It has some effect in aGVHD post matched
sibling or unrelated donor transplants although it's also associated
with poor survival and many people have stopped using it. I would wonder
if it would have much if any effect on transfusion associated GvHD??

Morton J. Cowan, M.D.
Professor of Pediatrics
Chief, BMT Division
UCSF Children's Hospital, Room M659
505 Parnassus Ave
San Francisco, CA 94143-1278
phone: 415-476-2188 
fax: 415-502-4867 
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-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of David Nelson
Sent: Saturday, February 10, 2007 3:20 PM
To: pagid at list.clinimmsoc.org
Subject: Re: [PAGID] Complete DiGeorge options

I would suppress the GVHD with saturating doses of humanized anti-Tac 
and then let host cells develop independently of IL-2 as they do in 
the IL-2Ra KO mouse or IL-2Ra deficient humans.

Then I would taper off the anti-Tac and let the host IL-2Ra+ Tregs 
develop to prevent the autoimmunity.  The engrafted cells should be 
very susceptible to IL-2 deprivation apoptosis.  Saturation could be 
examined using a combination of directly-conjugated anti-Tac and 
7G7/B6 staining of IL-2Ra.  When saturated with anti-Tac there is no 
anti-Tac staining but 7G7/B6 still reveals the IL-2Ra positive cells.

This is what we have don for pediatric ATL patients in "autocrine
phase".

David L. Nelson, M. D.
Metabolism Branch, CCR, NCI
NIH
Bethesda, MD 20892