Infliximab for GVHD therapy in children
| Autor: | A Serrano, Ka Wah Chan, Andrew L. Gilman, Thomas Braun, B. Sleight |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Adolescent medicine.medical_treatment Anti-Inflammatory Agents Drug Resistance Graft vs Host Disease Hematopoietic stem cell transplantation Opportunistic Infections Gastroenterology immune system diseases Immunopathology Internal medicine medicine Humans Child skin and connective tissue diseases Mycosis Retrospective Studies Transplantation Hematology business.industry Antibodies Monoclonal Infant medicine.disease Infliximab Discontinuation stomatognathic diseases Treatment Outcome surgical procedures operative Child Preschool Immunology Drug Evaluation Female Pulmonary hemorrhage business Complication medicine.drug |
| Zdroj: | Bone Marrow Transplantation. 40:473-480 |
| ISSN: | 1476-5365 0268-3369 |
| DOI: | 10.1038/sj.bmt.1705761 |
| Popis: | GVHD remains a significant complication of allogeneic hematopoietic stem cell transplantation. Tumor necrosis factor-alpha (TNF-alpha) is a major mediator of GVHD pathogenesis. Infliximab inhibits the binding of TNF-alpha with its cellular receptors and has been associated with encouraging responses in adults with severe GVHD. We retrospectively evaluated the efficacy and safety of infliximab 10 mg/kg i.v. once a week for a median of eight doses (range 1-162) in 24 children with steroid-resistant GVHD. The overall response rate in 22 evaluable children was 82% (12 CR+6 PR). Among those patients with acute GVHD, both skin and gastrointestinal involvement responded well to infliximab; however long-term outcome was poor. While infliximab may be useful to acutely control GVHD manifestations, GVHD recurs commonly upon discontinuation of infliximab. Within 100 days of the final infliximab dose, 77% of patients had bacterial infections, 32% had viral infections and 13.6% had probable or proven non-candidal invasive fungal infections. Infliximab appears to be well-tolerated and to have activity in steroid-resistant GVHD. Controlled studies to assess the pharmacokinetics and most effective dosing regimen of infliximab for the treatment of GVHD are warranted. |
| Databáze: | OpenAIRE |
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