A three or more drug combination as effective therapy for moderate or severe chronic graft-versus-host disease.

Abstract

We analyzed the results of a three or more drug combination as treatment for moderate or severe cGVHD developing after transplantation for thalassemia, in 45 patients with median age of 11 (range 2-26) years. Eighteen patients received a three drug regimen with cyclosporine (CsA), methylprednisolone (MP) and azathioprine (AZ) as first line therapy, 16 patients received this regimen as salvage therapy and 11 patients were given a four or five drug regimen with CsA, MP, AZ, cyclophosphamide (CY) and/or methotrexate (MTX) mainly as salvage therapy. The overall complete response (CR) rate was 77.3%, with 94% of CR in patients receiving the three drug regimen as first line, 88% in patients receiving it as salvage therapy and 36.6% in patients given the four or five drug regimen. The probability of CR in patients given the three drug regimen as first or salvage therapy or the four/five drug regimen was 89%, 53% and 30%, while the probability of survival was 89%, 65% and 58%, respectively. The incidence of treatment failure was low in our patients. Patients treated with the three drug regimen as first line therapy had less treatment-related complications than patients receiving this regimen as salvage therapy or patients given the four or five drug regimen. The main causes of treatment-related mortality (20%) were infectious complications. This retrospective study showed that a three or more drug combination is safe and effective for treatment of moderate or severe cGVHD at least in younger patients.

• Authors: D Gaziev, G Lucarelli, P Polchi, E Angelucci, M Galimberti, C Giardini, D Baronciani, B Erer, P Sodani
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 27 Issue 1 Pg. 45-51 (Jan 2001) ISSN: 0268-3369 [Print] England
• PMID: 11244437 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Immunosuppressive Agents

Topics

• Adolescent
• Adult
• Bone Marrow Transplantation (adverse effects, mortality)
• Child
• Child, Preschool
• Disease-Free Survival
• Drug Therapy, Combination
• Female
• Graft vs Host Disease (drug therapy, mortality)
• Humans
• Immunosuppressive Agents (administration & dosage, standards, toxicity)
• Infections (chemically induced)
• Male
• Salvage Therapy (methods, mortality, standards)
• Thalassemia (complications, therapy)
• Treatment Outcome