Successful treatment of steroid-refractory hepatitic variant of
liver graft-vs-host disease with pulse cyclophosphamide

J 2009

Successful treatment of steroid-refractory hepatitic variant of liver graft-vs-host disease with pulse cyclophosphamide

MAYER, Jiří, Marta KREJČÍ, Zdeněk POSPÍŠIL, Michael DOUBEK, Andrea JANÍKOVÁ et. al.

Basic information

Original name

Successful treatment of steroid-refractory hepatitic variant of liver graft-vs-host disease with pulse cyclophosphamide

Name in Czech

Úspěšná léčba steroid-refraktorní hepatitické varianty jaterní GvHD cyclophosphamidovými pulsy

Authors

MAYER, Jiří (203 Czech Republic, guarantor, belonging to the institution), Marta KREJČÍ (203 Czech Republic, belonging to the institution), Zdeněk POSPÍŠIL (203 Czech Republic, belonging to the institution), Michael DOUBEK (203 Czech Republic, belonging to the institution), Andrea JANÍKOVÁ (203 Czech Republic, belonging to the institution), Daniela ŽÁČKOVÁ (203 Czech Republic, belonging to the institution), Zdeněk RÁČIL (203 Czech Republic, belonging to the institution), Lenka ŠMARDOVÁ (203 Czech Republic, belonging to the institution), Milan NAVRÁTIL (203 Czech Republic, belonging to the institution) and Jan KAMELANDER (203 Czech Republic, belonging to the institution)

Edition

Experimental Hematology, Elsevier, 2009, 0301-472X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 3.106

RIV identification code

RIV/00216224:14110/09:00067130

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.exphem.2009.03.006

UT WoS

000266458200012

Keywords in English

STEM-CELL TRANSPLANTATION; BONE-MARROW TRANSPLANTATION; DONOR LYMPHOCYTE INFUSION; ANTI-THYMOCYTE GLOBULIN; ACUTE GVHD; RETROSPECTIVE ANALYSIS; THERAPY; BLOOD

Abstract

ORIG CZ

V originále

Objective. Corticosteroid-resistant graft-vs-host disease (GVHD) is difficult to manage and is associated with high morbidity and mortality. No standard treatment exists. We have previously seen good results with pulse cyclophosphamide (Cy) in the treatment of liver GVHD in contrast to gastrointestinal GVHD, and here we report results of pulse Cy protocol in the treatment of steroid-refractory hepatitic variant of liver GVHD, with no association to the gut. Materials and Methods. Cy was infused at a dose of 1,000 mg/m(2). Twenty-nine cyclophosphamide administrations were given to 21 patients. Median time of GVHD onset and Cy administration after transplantation, or donor lymphocyte infusion, were 58 and 69 days, respectively. Results. Eleven patients (52%) achieved complete remission and 6 patients (29%) achieved partial remission. Four patients (19%) did not respond, however, their condition stabilized and, upon additional therapy, three achieved partial remission and one complete remission. Overall survival of all 21 patients is 86%, with median and maximal follow-up of 33 and 81 months, respectively. Toxicity was mild and easily manageable without influencing chimerism or disease status. Conclusions. Pulse Cy seems to be an effective treatment for steroid-refractory hepatitic variant of liver GVHD with a good toxicity profile, which may favor its use instead of drugs with more pronounced immunosuppressive effects.

In Czech

Pulsní Cy se ukazuje jako účinný prostředek při léčbě jaterní GvHD.

Links

MSM0021622430, plan (intention)

Name: Funkční a molekulární charakteristiky nádorových a normálních kmenových buněk - identifikace cílů pro nová terapeutika a terapeutické strategie

Investor: Ministry of Education, Youth and Sports of the CR, Functional and molecular characteristics of cancer and normal stem cells - identification of targets for novel therapeutics and therapeutic strategies

Citovat

MAYER, Jiří, Marta KREJČÍ, Zdeněk POSPÍŠIL, Michael DOUBEK, Andrea JANÍKOVÁ, Daniela ŽÁČKOVÁ, Zdeněk RÁČIL, Lenka ŠMARDOVÁ, Milan NAVRÁTIL and Jan KAMELANDER. Successful treatment of steroid-refractory hepatitic variant of liver graft-vs-host disease with pulse cyclophosphamide. Experimental Hematology. Elsevier, 2009, vol. 37, No 6, p. 767-773. ISSN 0301-472X. Available from: https://dx.doi.org/10.1016/j.exphem.2009.03.006.

@article{837827,
   author = {Mayer, Jiří and Krejčí, Marta and Pospíšil, Zdeněk and Doubek, Michael and Janíková, Andrea and Žáčková, Daniela and Ráčil, Zdeněk and Šmardová, Lenka and Navrátil, Milan and Kamelander, Jan},
   article_number = {6},
   doi = {http://dx.doi.org/10.1016/j.exphem.2009.03.006},
   keywords = {STEM-CELL TRANSPLANTATION; BONE-MARROW TRANSPLANTATION; DONOR LYMPHOCYTE INFUSION; ANTI-THYMOCYTE GLOBULIN; ACUTE GVHD; RETROSPECTIVE ANALYSIS; THERAPY; BLOOD},
   language = {eng},
   issn = {0301-472X},
   journal = {Experimental Hematology},
   title = {Successful treatment of steroid-refractory hepatitic variant of liver graft-vs-host disease with pulse cyclophosphamide},
   volume = {37},
   year = {2009}
}

TY  - JOUR
ID  - 837827
AU  - Mayer, Jiří - Krejčí, Marta - Pospíšil, Zdeněk - Doubek, Michael - Janíková, Andrea - Žáčková, Daniela - Ráčil, Zdeněk - Šmardová, Lenka - Navrátil, Milan - Kamelander, Jan
PY  - 2009
TI  - Successful treatment of steroid-refractory hepatitic variant of liver graft-vs-host disease with pulse cyclophosphamide
JF  - Experimental Hematology
VL  - 37
IS  - 6
SP  - 767-773
EP  - 767-773
PB  - Elsevier
SN  - 0301472X
KW  - STEM-CELL TRANSPLANTATION
KW  - BONE-MARROW TRANSPLANTATION
KW  - DONOR LYMPHOCYTE INFUSION
KW  - ANTI-THYMOCYTE GLOBULIN
KW  - ACUTE GVHD
KW  - RETROSPECTIVE ANALYSIS
KW  - THERAPY
KW  - BLOOD
N2  - Objective. Corticosteroid-resistant graft-vs-host disease (GVHD) is difficult to manage and is associated with high morbidity and mortality. No standard treatment exists. We have previously seen good results with pulse cyclophosphamide (Cy) in the treatment of liver GVHD in contrast to gastrointestinal GVHD, and here we report results of pulse Cy protocol in the treatment of steroid-refractory hepatitic variant of liver GVHD, with no association to the gut. Materials and Methods. Cy was infused at a dose of 1,000 mg/m(2). Twenty-nine cyclophosphamide administrations were given to 21 patients. Median time of GVHD onset and Cy administration after transplantation, or donor lymphocyte infusion, were 58 and 69 days, respectively. Results. Eleven patients (52%) achieved complete remission and 6 patients (29%) achieved partial remission. Four patients (19%) did not respond, however, their condition stabilized and, upon additional therapy, three achieved partial remission and one complete remission. Overall survival of all 21 patients is 86%, with median and maximal follow-up of 33 and 81 months, respectively. Toxicity was mild and easily manageable without influencing chimerism or disease status. Conclusions. Pulse Cy seems to be an effective treatment for steroid-refractory hepatitic variant of liver GVHD with a good toxicity profile, which may favor its use instead of drugs with more pronounced immunosuppressive effects.
ER  -

MAYER, Jiří, Marta KREJČÍ, Zdeněk POSPÍŠIL, Michael DOUBEK, Andrea JANÍKOVÁ, Daniela ŽÁČKOVÁ, Zdeněk RÁČIL, Lenka ŠMARDOVÁ, Milan NAVRÁTIL and Jan KAMELANDER. Successful treatment of steroid-refractory hepatitic variant of liver graft-vs-host disease with pulse cyclophosphamide. \textit{Experimental Hematology}. Elsevier, 2009, vol.~37, No~6, p.~767-773. ISSN~0301-472X. Available from: https://dx.doi.org/10.1016/j.exphem.2009.03.006.

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