Prevention of regimen-related toxicities after bone marrow transplantation by pentoxifylline: a prospective, randomized trial
| Autor: | Jean-Paul Charlet, Guy Laurent, Jacques Pris, Françoise Huguet, Hervé Rubie, Anne Huynh, Michel Attal, Daniel Schlaifer |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Immunology Biochemistry Gastroenterology Pentoxifylline law.invention chemistry.chemical_compound Randomized controlled trial Oral administration law Internal medicine medicine Mucositis Humans Prospective Studies Prospective cohort study Bone Marrow Transplantation Chemotherapy Creatinine business.industry Drug Tolerance Cell Biology Hematology Middle Aged medicine.disease Hematopoiesis Surgery Regimen chemistry Patient Compliance Female business medicine.drug |
| Zdroj: | Blood. 82:732-736 |
| ISSN: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood.v82.3.732.732 |
| Popis: | Elevated levels of tumor necrosis factor alpha (TNF-alpha) have been reported to correlate with the development of transplant-related complications after bone marrow transplantation (BMT). In a recent phase I-II trial, oral administration of pentoxifylline (PTX), a xanthine derivative capable of downregulating TNF-alpha production in vitro, was reported to reduce morbidity and mortality in patients undergoing BMT. We conducted a prospective randomized trial of PTX therapy among 140 patients undergoing either allogeneic (n = 51) or autologous BMT (n = 89). Patients were randomized to receive (n = 70) or not receive (n = 70) oral PTX, 1,600 mg/d in four divided doses from day -8 until day + 100 post-BMT. The incidence of mucositis requiring morphine sulfate (MSO4) was similar in both groups (42.9%), with the mean number of days with MSO4 being 7.8 (SD = 3.4) in the PTX group versus 8.2 (SD = 3.4) in the control group (NS). The incidence of renal insufficiency was not affected by PTX administration (15.7% in the PTX group v 21.4% in the control group [NS]) and the highest serum creatinine value during the first 100 days post-BMT was 119 mumol/L (SD = 82.4) in the PTX group versus 103.9 mumol/L (SD = 57) in the control group (NS). The incidence of grade > or = 2 graft-versus-host disease was similar in each group (11/25 [44%] in the PTX group v 12/26 [46%] in the control group). No significant difference was observed in hematologic toxicity, transfusion requirements, duration of fever, and hepatic toxicity between the treatment groups. In conclusion, our study failed to show a prophylactic effect of PTX in transplant-related toxicities after BMT. On the basis of these findings, we cannot recommend that PTX be part of early mortality and morbidity prevention programs after BMT. |
| Databáze: | OpenAIRE |
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