Document Detail


Encouraging preliminary results in 12 patients with high-risk haematological malignancies by omitting graft-versus-host disease prophylaxis after allogeneic transplantation.
MedLine Citation:
PMID:  11122119     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Immunosuppressive therapy, routinely given after allogeneic transplantation to modulate graft-versus-host disease (GVHD) may have an adverse effect on the graft-versus-tumour (GVT) effect. Twelve patients with high-risk haematological malignancies were given cyclophosphamide, total body irradiation and antithymocyte globulin followed by peripheral blood stem cell grafts from HLA-identical siblings without prophylactic immunosuppression. At the earliest clinical evidence of GVHD, patients were treated with high-dose solumedrol and tacrolimus. Prompt haematological recovery [absolute neutrophil count (ANC) > 1.0 x 109/l] was observed (median time 9 d). All patients developed grade III-IV GVHD (median onset 9 d), involving the skin (11), intestine (five) and liver (three). Of nine evaluable patients, seven developed chronic GVHD [extensive (six), limited (one)]. Six patients died 1-6.5 months after transplantation. Three patients died from treatment-related complications, two from acute GVHD and one from relapsing disease. The remaining six patients are alive 5-26 months after transplantation, five in complete remission and one myeloma patient in very good partial remission. In conclusion, omission of post-transplantation GVHD prophylaxis is feasible, does not lead to graft failure or a high incidence of uncontrollable GVHD and appears to be associated with encouraging clinical responses in a group of patients with high-risk disease features.
Authors:
A B Fassas; A P Rapoport; M Cottler-Fox; T Chen; G Tricot
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of haematology     Volume:  111     ISSN:  0007-1048     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-01-08     Completed Date:  2001-02-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  662-7     Citation Subset:  IM    
Affiliation:
Bone Marrow Transplant Program, Department of Internal Medicine, University of Maryland, Baltimore, MD, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Bone Marrow Transplantation*
Female
Follow-Up Studies
Glucocorticoids / therapeutic use
Graft vs Host Disease / drug therapy
Graft vs Tumor Effect*
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / immunology,  surgery*
Leukemia, Myeloid / immunology,  surgery*
Leukemia-Lymphoma, Adult T-Cell / immunology,  surgery
Lymphoma, B-Cell / immunology,  surgery*
Lymphoma, Mantle-Cell / immunology,  surgery
Male
Middle Aged
Multiple Myeloma / immunology,  surgery
Pilot Projects
Prednisone / therapeutic use
Transplantation, Homologous
Chemical
Reg. No./Substance:
0/Glucocorticoids; 53-03-2/Prednisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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