A pilot study of low-dose cyclosporin for graft-versus-host prophylaxis in marrow transplantation
| Autor: | George B. McDonald, Claudio Anasetti, Kris Doney, Keith M. Sullivan, Frederick R. Appelbaum, Paul J. Martin, Marcus Stockschlaeder, Robert P. Witherspoon, Gary Longton, Margaret S. Pepe, Rainer Storb |
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| Rok vydání: | 1992 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Graft vs Host Disease Cyclosporins Pilot Projects Gastroenterology Drug Administration Schedule Immunopathology Internal medicine medicine Humans Cumulative incidence Child Bone Marrow Transplantation Chemotherapy business.industry Incidence (epidemiology) Low dose Bilirubin Immunosuppression Hematology Middle Aged Surgery Methotrexate Child Preschool Acute Disease Toxicity Drug Therapy Combination Female business medicine.drug |
| Zdroj: | British Journal of Haematology. 80:49-54 |
| ISSN: | 1365-2141 0007-1048 |
| DOI: | 10.1111/j.1365-2141.1992.tb06399.x |
| Popis: | Summary. Nineteen patients with leukaemia, preleukaemia, and aplastic anaemia were treated by marrow transplantation from HLA-identical siblings. All were given postgrafting immunosuppression with a combination of methotrexate (days 1,3,6 and 11) and cyclosporin (days -1 to 180). In an attempt at reducing cyclosporin-associated toxicity, we explored whether the cyclosporin dose during the first 2 weeks could be decreased by 50% (from 3.0 to 1.5 mg/kg/d intravenously) without adversely affecting the incidence, onset, and severity of acute graft-versus-host disease (GVHD) and overall survival. Results from this pilot study were compared to those of a matched cohort of 38 patients given a standard dose of 3.0 mg cyclosporin/kg/d starting on day -1. The cumulative incidence of grade II and III acute GVHD in the ‘low dose’ cyclosporin group was 42% compared to 51% in the ‘standard dose’ group (P= 0.60). Three-year survival was 63% and 54% respectively (P=0.59). Patients receiving the reduced cyclosporin dose during the first 14 d appeared to have less hepatotoxicity, and the methotrexate and cyclosporin doses administered were closer to the doses intended per protocol. We suggest that‘low dose’cyclosporin from day -1 to day 15 postgrafting might be as effective as ‘standard dose’ cyclosporin during that time period for the prevention of acute GVHD. |
| Databáze: | OpenAIRE |
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