The role of thalidomide in the treatment of refractory chronic graft-versus-host disease following bone marrow transplantation in children

被引:63
作者
Rovelli, A
Arrigo, C
Nesi, F
Balduzzi, A
Nicolini, B
Locasiulli, A
Vassallo, E
Miniero, R
Uderzo, C
机构
[1] Univ Milan, Osped San Gerardo, Pediat Clin, I-20052 Monza, Italy
[2] Univ Turin, Dipartimento Sci Pediat & Adolsecenza, Turin, Italy
关键词
bone marrow transplantation; children; graft-versus-host disease; thalidomide;
D O I
10.1038/sj.bmt.1701138
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Chronic graft-versus-host disease (cGVHD) is a frequent complication of allogeneic bone marrow transplantation (BMT). Thalidomide was found to have immunosuppressive properties and it has been used in a limited number of children with cGVHD, We report our experience with refractory and/or high-risk cGVHD in 14 children, Six children showed complete clinical response to thalidomide in a median time of 2 months, Four children had partial responses and four failed, Side-effects were usually mild (somnolence, constipation) and only two patients developed sensory peripheral neuropathy. An increased incidence of infectious complications attributable to thalidomide was not observed, Nine out of 10 responding patients are alive 49-111 months post-BMT, Thalidomide can be effective particularly in children with prevailing mucocutaneous cGVHD. All patients should be carefully monitored to detect peripheral neuropathy early.
引用
收藏
页码:577 / 581
页数:5
相关论文
共 23 条
[1]   PROSPECTIVE COMPARATIVE-STUDY OF BONE-MARROW TRANSPLANTATION AND POSTREMISSION CHEMOTHERAPY FOR CHILDHOOD ACUTE MYELOGENOUS LEUKEMIA [J].
AMADORI, S ;
TESTI, AM ;
ARICO, M ;
COMELLI, A ;
GIULIANO, M ;
MADON, E ;
MASERA, G ;
RONDELLI, R ;
ZANESCO, L ;
MANDELLI, F .
JOURNAL OF CLINICAL ONCOLOGY, 1993, 11 (06) :1046-1054
[2]  
CHEN TL, 1989, DRUG METAB DISPOS, V17, P402
[3]  
COLE CH, 1994, BONE MARROW TRANSPL, V14, P937
[4]  
FERRARA JLM, 1991, NEW ENGL J MED, V324, P667
[5]  
Forsyth CJ, 1996, BONE MARROW TRANSPL, V17, P291
[6]   THALIDOMIDE TREATMENT FOR CHRONIC GRAFT-VERSUS-HOST DISEASE [J].
HENEY, D ;
NORFOLK, DR ;
WHEELDON, J ;
BAILEY, CC ;
LEWIS, IJ ;
BARNARD, DL .
BRITISH JOURNAL OF HAEMATOLOGY, 1991, 78 (01) :23-27
[7]  
HENEY D, 1988, LANCET, V2, P1317
[8]   IMMUNOSUPPRESSIVE PROPERTIES OF THALIDOMIDE - INHIBITION OF INVITRO LYMPHOCYTE-PROLIFERATION ALONE AND IN COMBINATION WITH CYCLOSPORINE OR FK506 [J].
KEENAN, RJ ;
EIRAS, G ;
BURCKART, GJ ;
STUART, RS ;
HARDESTY, RL ;
VOGELSANG, G ;
GRIFFITH, BP ;
ZEEVI, A .
TRANSPLANTATION, 1991, 52 (05) :908-910
[9]  
LOCATELLI F, 1993, BONE MARROW TRANSPL, V12, P627
[10]  
LOPEZ J, 1993, BONE MARROW TRANSPL, V11, P251