J 2005

Pulse cyclophosphamide for corticosteroid-refractory graft-versus-host disease.

MAYER, Jiří, Marta KREJČÍ, M. DOUBEK, Z. POSPÍŠIL, Yvona BRYCHTOVÁ et. al.

Basic information

Original name

Pulse cyclophosphamide for corticosteroid-refractory graft-versus-host disease.

Name in Czech

Puls cyklofosfamidu na kortikoid-rezistentní GVHD.

Authors

MAYER, Jiří, Marta KREJČÍ, M. DOUBEK, Z. POSPÍŠIL, Yvona BRYCHTOVÁ, Miroslav TOMIŠKA and Zdeněk RÁČIL

Edition

Bone Marrow Transplantation, London, Nature publishing group, 2005, 0268-3369

Other information

Type of outcome

Článek v odborném periodiku

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 2.643

Organization unit

Faculty of Medicine

UT WoS

000227827100009

Keywords (in Czech)

akutní GVHD, cyklofosfamid, imunosuprese

Keywords in English

acute GVHD; cyclophosphamide; immunosuppression
Změněno: 3/11/2010 15:13, prof. MUDr. Zdeněk Ráčil, Ph.D.

Abstract

V originále

Corticosteroid-resistant GVHD is difficult to manage and is associated with high morbidity and mortality. Cyclophosphamide (Cy) is an established immunosuppressive and cytotoxic drug widely used as part of pretransplant conditioning regimens. In a retrospective study of 15 patients who had not responded to corticosteroids (nine with acute GVHD, three with GVHD after donor leukocyte infusion, and three progressive chronic GVHD), pulse Cy at a median dose of 1 g/m(2) was very effective in the treatment of skin (100% response), liver (70% response), and the oral cavity (100% response). Severe intestinal GVHD responded poorly. The toxicity pro. le was acceptable, with manageable, short-term myelosuppression in some patients. The risk of opportunistic infections, mixed chimerism, relapses, or post-transplant lymphoproliferative disease was not increased. Overall survival was 57%, with median and maximum follow-up of 9 and 37 months, respectively. The cost of the drug was negligible, especially when compared to monoclonal antibodies. Pulse Cy requires further investigation in corticosteroid-resistant GVHD.