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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
1
|
| pubmed:dateCreated |
1995-12-8
|
| pubmed:abstractText |
Twenty-eight consecutive recipients of HLA-identical sibling marrow grafts received prophylaxis for GVHD with high-dose cyclosporine (CsA) and corticosteroids. CsA 5 mg/kg/day (2.5 mg/kg infused over 4 h twice daily) was started on day -1 and continued until patients could take oral CsA (15 mg/kg/day). CsA doses were adjusted to maintain concentrations between 200-800 ng/ml (whole-blood HPLC) until the tapering period (days 268-361). Methylprednisolone 0.5 mg/kg/day was started on day 7, increased to 1 mg/kg/day during days 15-28, and tapered thereafter until discontinuance on day 194. Low CsA trough levels occurred in 15 patients (54%) during the i.v. administration period. Ten patients (36%) developed grade I and 3 patients (11%) developed grade II acute GVHD; there were no cases of grade III or IV disease. The actuarial incidence of chronic GVHD was 29% at 1 year but 57% at 2 years due to development of chronic GVHD after discontinuation of immunosuppressive agents. High blood CsA concentrations in stable outpatients led to dose-limiting nephrotoxicity. Infections occurred throughout the period of extended immunosuppression (from 6 to 12 months) but were not life-threatening. The actuarial incidence of leukemic relapse was 18% at 1 year and 25% at 2 years. Actuarial survival at 1 and 2 years was 68 and 51%, respectively. Despite the frequent occurrence of low CsA trough levels, this regimen appeared to be effective in preventing acute GVHD. Immunosuppressive prophylaxis beyond 1 year may be required to reduce late-onset chronic GVHD.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:month |
Jul
|
| pubmed:issn |
0268-3369
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
16
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
147-54
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:7581115-Adolescent,
pubmed-meshheading:7581115-Adrenal Cortex Hormones,
pubmed-meshheading:7581115-Adult,
pubmed-meshheading:7581115-Bone Marrow Transplantation,
pubmed-meshheading:7581115-Cyclosporine,
pubmed-meshheading:7581115-Female,
pubmed-meshheading:7581115-Follow-Up Studies,
pubmed-meshheading:7581115-Graft vs Host Disease,
pubmed-meshheading:7581115-Humans,
pubmed-meshheading:7581115-Immunosuppressive Agents,
pubmed-meshheading:7581115-Male,
pubmed-meshheading:7581115-Middle Aged,
pubmed-meshheading:7581115-Survival Analysis,
pubmed-meshheading:7581115-Transplantation, Homologous
|
| pubmed:year |
1995
|
| pubmed:articleTitle |
High-dose cyclosporine and corticosteroids for prophylaxis of acute and chronic graft-versus-host disease.
|
| pubmed:affiliation |
Pittsburgh Cancer Institute Adult Bone Marrow Transplant Unit, Montefiore University Hospital, University of Pittsburgh Medical Center, PA, USA.
|
| pubmed:publicationType |
Journal Article
|