NDLI: Addition of Infliximab to Standard Acute Graft-versus-Host Disease Prophylaxis Following Allogeneic Peripheral Blood Cell Transplantation

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Addition of Infliximab to Standard Acute Graft-versus-Host Disease Prophylaxis Following Allogeneic Peripheral Blood Cell Transplantation

Content Provider	PubMed Central
Author	Hamadani, Mehdi Hofmeister, Craig C. Buffy, Jansak Phillips, Gary Elder, Patrick Blum, William Penza, Sam Lin, Thomas S. Rebecca, Klisovic Marcucci, Guido Farag, Sherif S. Devine, Steven M.
Abstract	Infliximab, a chimeric monoclonal antibody against tumor necrosis factor-α, has shown activity against steroid refractory acute graft-versus-host disease (GVHD). We conducted a prospective trial of infliximab for the prophylaxis of acute GVHD. Patients older than 20 years undergoing myeloablative allogeneic stem cell transplantation for hematologic malignancies were eligible. GVHD prophylaxis consisted of infliximab given one day prior to conditioning and then on days 0, +7, +14, +28 and +42, together with standard cyclosporine and methotrexate. Nineteen patients with a median age of 53 years were enrolled. All patients received peripheral blood allografts from matched sibling (n=14) or unrelated donors (n=5). Results were compared with a matched historical control group (n=30) treated contemporaneously at our institution. The cumulative incidences of grades II–IV acute GVHD in the infliximab and control groups were 36.8% and 36.6% respectively (p=0.77). Rates of chronic GVHD were 78% and 61% respectively (p=0.22). Significantly more bacterial and invasive fungal infections were observed in the infliximab group (p=0.01 and p=0.02 respectively). Kaplan-Meier estimates of 2 year overall survival and progression free survival for patients receiving infliximab were 42% and 36% respectively. The corresponding numbers for patients in the control group were 46% and 43% respectively. The addition of infliximab to standard GVHD prophylaxis did not lower the risk of GVHD and was associated with an increased risk of bacterial and invasive fungal infections.
Related Links	http://dx.doi.org/10.1016/j.bbmt.2008.04.006
Ending Page	789
Page Count	7
Starting Page	783
File Format	PDF
ISSN	10838791
e-ISSN	15236536
Journal	Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Issue Number	7
Volume Number	14
Language	English
Publisher Date	2008-07-01
Access Restriction	Open
Subject Keyword	Transplantation Hematology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Hematology Transplantation

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