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Prophylaxis for acute graft-versus-host disease following unrelated donor bone marrow transplantation.
Bone Marrow Transplant. 1995 Feb; 15(2):213-9.BM

Abstract

Despite the use of conventional chemoprophylaxis regimens, patients receiving unrelated-donor BMT are at high risk of developing severe acute GVHD. We evaluated a prophylactic regimen combining CsA, MTX and anti-CD5-ricin A chain immunotoxin (H65-RTA) in 31 patients; pentoxifylline was also given to reduce the anticipated nephrotoxicity of CsA. In most cases, planned doses of CsA, MTX and H65-RTA were given (i.e. to 77%, 77% and 93% of patients, respectively). Although fluid retention requiring diuretic therapy was frequent, only 1 patient had a > 10% unexplained increase in body weight during the first 21 days post-BMT. Also, while significant increase of the baseline serum creatinine was noted in 7 patients, none required dialysis. One patient suffered a reversible allergic reaction to the immunotoxin; no other side effects attributable to this regimen were observed. All but 2 patients engrafted (1 died of fungemia on d + 19 and the other had persistent leukemia) and no late graft failures were observed. Seventeen patients developed acute GVHD grade > or = II (probability, 58% [95% CI 41-76%]); 7 had grade > or = III (probability, 24% [95% CI 12-43%]). In the 27 patients who achieved stable engraftment and have survived beyond d + 100, the 3-year probability of developing chronic GVHD was 66% (95% CI 48-84%). As of the last follow-up prior to 01 May 1994, 13 patients are alive in CR and one in relapse; 9 of these patients are off all immunosuppressives and well. Four other patients relapsed and died, and 13 died of other transplant-related causes.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Leukemia/Bone Marrow Transplantation Program of British Columbia, Vancouver Hospital and Health Sciences Centre, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7539667

Citation

Phillips, G L., et al. "Prophylaxis for Acute Graft-versus-host Disease Following Unrelated Donor Bone Marrow Transplantation." Bone Marrow Transplantation, vol. 15, no. 2, 1995, pp. 213-9.
Phillips GL, Nevill TJ, Spinelli JJ, et al. Prophylaxis for acute graft-versus-host disease following unrelated donor bone marrow transplantation. Bone Marrow Transplant. 1995;15(2):213-9.
Phillips, G. L., Nevill, T. J., Spinelli, J. J., Nantel, S. H., Klingemann, H. G., Barnett, M. J., Shepherd, J. D., Chan, K. W., Meharchand, J. M., & Sutherland, H. J. (1995). Prophylaxis for acute graft-versus-host disease following unrelated donor bone marrow transplantation. Bone Marrow Transplantation, 15(2), 213-9.
Phillips GL, et al. Prophylaxis for Acute Graft-versus-host Disease Following Unrelated Donor Bone Marrow Transplantation. Bone Marrow Transplant. 1995;15(2):213-9. PubMed PMID: 7539667.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylaxis for acute graft-versus-host disease following unrelated donor bone marrow transplantation. A1 - Phillips,G L, AU - Nevill,T J, AU - Spinelli,J J, AU - Nantel,S H, AU - Klingemann,H G, AU - Barnett,M J, AU - Shepherd,J D, AU - Chan,K W, AU - Meharchand,J M, AU - Sutherland,H J, PY - 1995/2/1/pubmed PY - 1995/2/1/medline PY - 1995/2/1/entrez SP - 213 EP - 9 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 15 IS - 2 N2 - Despite the use of conventional chemoprophylaxis regimens, patients receiving unrelated-donor BMT are at high risk of developing severe acute GVHD. We evaluated a prophylactic regimen combining CsA, MTX and anti-CD5-ricin A chain immunotoxin (H65-RTA) in 31 patients; pentoxifylline was also given to reduce the anticipated nephrotoxicity of CsA. In most cases, planned doses of CsA, MTX and H65-RTA were given (i.e. to 77%, 77% and 93% of patients, respectively). Although fluid retention requiring diuretic therapy was frequent, only 1 patient had a > 10% unexplained increase in body weight during the first 21 days post-BMT. Also, while significant increase of the baseline serum creatinine was noted in 7 patients, none required dialysis. One patient suffered a reversible allergic reaction to the immunotoxin; no other side effects attributable to this regimen were observed. All but 2 patients engrafted (1 died of fungemia on d + 19 and the other had persistent leukemia) and no late graft failures were observed. Seventeen patients developed acute GVHD grade > or = II (probability, 58% [95% CI 41-76%]); 7 had grade > or = III (probability, 24% [95% CI 12-43%]). In the 27 patients who achieved stable engraftment and have survived beyond d + 100, the 3-year probability of developing chronic GVHD was 66% (95% CI 48-84%). As of the last follow-up prior to 01 May 1994, 13 patients are alive in CR and one in relapse; 9 of these patients are off all immunosuppressives and well. Four other patients relapsed and died, and 13 died of other transplant-related causes.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/7539667/Prophylaxis_for_acute_graft_versus_host_disease_following_unrelated_donor_bone_marrow_transplantation_ L2 - http://www.diseaseinfosearch.org/result/7171 DB - PRIME DP - Unbound Medicine ER -