Fresh frozen plasma and platelet concentrates may increase plasma anti-diphtheria toxin IgG concentrations: Implications for diphtheria fusion protein therapy

Philip D. Hall, Debajyoti Sinha, Arthur E. Frankel

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We are developing two fusion proteins consisting of a diphtheria toxin (DT) linked to either granulocyte macrophage colony stimulating factor (DT388-GMCSF) or interleukin-3 (DT388-ILS). In trials, patients with anti-DT IgG concentrations >2.5 μg/ml had significantly lower concentrations of either fusion protein. DT389-IL2 is currently FDA approved for the treatment of cutaneous T-cell lymphomas. We noted increased concentrations of anti-DT IgG after administration of platelet concentrates (PC). Because many of these patients require transfusions, we measured the anti-DT IgG content of FFP and PC. We assayed 14 bags of FFP and 12 bags of single-donor PCs for anti-DT IgG by an enzymoimmunoassay against DT389-IL2, DT388-IL3, DT388-GMCSF. The median (percent of samples positive) of anti-DT IgG concentrations in PC against DT388-GMCSF, DT388-IL3, DT389-IL2 was 0.8 μg/ml (83%), 0.7 μg/ml (83%), and 0.3 μg/ml (58%), respectively. The median (percent of samples positive) anti-DT IgG concentration in FFP against DT388-GMCSF, DT388-IL3, and DT389-IL2 was 2.1 μg/ ml (86%), 1.9 μg/ml (93%), and 1.4 μg/ml (86%), respectively. There was a strong association between anti-DT389IL2 IgG, anti-DT388IL3 IgG, and anti-DT388GMCSF IgG concentrations in both the FFP (95.6%) and PC (76.3%). Assuming a plasma volume of 3 1 in a 70 kg patient, a single FFP unit would increase the plasma anti-DT389IL2 IgG, anti-DT388IL3 IgG, and anti-DT388GMCSF IgG by 0.13 μg/ml, 0.17 μg/ml, and 0.19 μg/ml, respectively. For PC, a single unit would increase plasma anti-DT389-IL2 IgG, anti-DT388-IL3 IgG, and anti-DT388-GMCSF IgG by 0.03 μg/ml, 0.06 μg/ml, and 0.07 μg/ml, respectively. In conclusion, a single FFP or PC appears to minimally increase anti-DT IgG concentrations, but multiple units may significantly do such.

Original languageEnglish (US)
Pages (from-to)928-932
Number of pages5
JournalCancer Immunology, Immunotherapy
Issue number8
Publication statusPublished - Aug 2006



  • Anti-DT IgG
  • Diphtheria fusion proteins
  • Fresh frozen plasma
  • Platelet concentrates

ASJC Scopus subject areas

  • Cancer Research
  • Immunology
  • Oncology

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