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rdf:type |
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lifeskim:mentions |
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pubmed:issue |
3
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pubmed:dateCreated |
2011-3-9
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pubmed:abstractText |
Treatment options for steroid-refractory GVHD (SR-GVHD) are unsatisfactory and prognosis is poor. Inflammatory cytokines IL-2 and TNF-? are important mediators of GVHD and may be critical targets for therapy. We retrospectively reviewed our experience using combination anti-cytokine therapy of daclizumab and infliximab. Seventeen evaluable patients had a median age of 47 years (range 35-63). The conditioning regimen was myeloablative in 13 and non-myeloablative in 4 cases. GVHD occurred at a median of 49 days after transplant in 12 patients (range 21-231 days) and at a median of 46 days (range 25-119 days) after donor lymphocyte infusion in 5 patients. All patients had persistent or progressive GVHD despite 1-2?mg/kg/day of corticosteroids for a median of 7 days (range 2-26 days). They received a combination of daclizumab and infliximab for acute GVHD IBMTR severity index B (3), C (10) or D (4). Of the 17 patients analyzed, 47% responded to treatment, 24% had complete resolution of symptoms and 24% had partial responses. Survival was limited and all the patients died a median of 6.7 months (range 1.6-26) from transplant and 35 days from initiation of daclizumab/infliximab. This retrospective analysis suggests that combination anti-cytokine therapy with daclizumab/infliximab has significant activity in SR-GVHD, but outcomes remain poor. New methods to prevent and treat GVHD are urgently needed.
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pubmed:grant |
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pubmed:commentsCorrections |
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-10607689,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-11260089,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-11438821,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-11498743,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-11939605,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-12171485,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-12855583,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-14604275,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-15009066,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-15069017,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-15138163,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-1515883,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-15531458,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-15806135,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-15886325,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-16098072,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-16261610,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-16984386,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-17234737,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-17618322,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-19443659,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-19648797,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-19660725,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-2015405,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-2207321,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-2302454,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-7581076,
http://linkedlifedata.com/resource/pubmed/commentcorrection/20498647-9217189
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pubmed:language |
eng
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pubmed:journal |
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pubmed:citationSubset |
IM
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pubmed:chemical |
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pubmed:status |
MEDLINE
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pubmed:month |
Mar
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pubmed:issn |
1476-5365
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pubmed:author |
pubmed-author:DavisJJ,
pubmed-author:FreyNN,
pubmed-author:GoldsteinS CSC,
pubmed-author:HexnerE OEO,
pubmed-author:LorenAA,
pubmed-author:LugerS MSM,
pubmed-author:PerzSS,
pubmed-author:PorterD LDL,
pubmed-author:RagerAA,
pubmed-author:ReshefRR,
pubmed-author:SmithJJ,
pubmed-author:StadtmauerE AEA,
pubmed-author:TsaiDD,
pubmed-author:VozniakMM
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pubmed:issnType |
Electronic
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pubmed:volume |
46
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
430-5
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pubmed:dateRevised |
2011-11-17
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pubmed:meshHeading |
pubmed-meshheading:20498647-Acute Disease,
pubmed-meshheading:20498647-Adult,
pubmed-meshheading:20498647-Antibodies, Monoclonal,
pubmed-meshheading:20498647-Antibodies, Monoclonal, Humanized,
pubmed-meshheading:20498647-Drug Resistance,
pubmed-meshheading:20498647-Female,
pubmed-meshheading:20498647-Graft vs Host Disease,
pubmed-meshheading:20498647-Humans,
pubmed-meshheading:20498647-Immunoglobulin G,
pubmed-meshheading:20498647-Immunosuppressive Agents,
pubmed-meshheading:20498647-Male,
pubmed-meshheading:20498647-Middle Aged,
pubmed-meshheading:20498647-Prognosis,
pubmed-meshheading:20498647-Retrospective Studies,
pubmed-meshheading:20498647-Steroids,
pubmed-meshheading:20498647-Survival Analysis,
pubmed-meshheading:20498647-Treatment Outcome
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pubmed:year |
2011
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pubmed:articleTitle |
Inflammatory cytokine inhibition with combination daclizumab and infliximab for steroid-refractory acute GVHD.
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pubmed:affiliation |
Division of Hematology-Oncology, Blood and Marrow Transplant Program, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA. alison.rager@uphs.upenn.edu
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pubmed:publicationType |
Journal Article,
Research Support, N.I.H., Extramural
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