NDLI: Sirolimus, tacrolimus, and low-dose methotrexate for graft-versus-host disease prophylaxis in mismatched related donor or unrelated donor transplantation

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Sirolimus, tacrolimus, and low-dose methotrexate for graft-versus-host disease prophylaxis in mismatched related donor or unrelated donor transplantation

Content Provider	Scilit
Author	Antin, Joseph H. Kim, Haesook T. Cutler, Corey Ho, Vincent T. Lee, Stephanie J. Miklos, David B. Hochberg, Ephraim P. Wu, Catherine J. Alyea, Edwin P. Soiffer, Robert J.
Copyright Year	2003
Description	We studied the feasibility and activity of adding sirolimus to tacrolimus and low-dose methotrexate as graft-versus-host disease (GVHD) prophylaxis in recipients of alternative donor transplants. Forty-one patients with hematologic malignancies were conditioned with cyclophosphamide and total body irradiation. Marrow stem cells were from an HLA-A, -B, and -DR compatible, unrelated donor (n = 26, 68%), froma5of6 antigen-matched unrelated donor (n = 8, 20%), or from a 5 of 6 antigen-matched family member (n = 5, 12%). Therapeutic serum levels of sirolimus were attained in most patients. All evaluable patients engrafted. An absolute neutrophil count of 500/μL was achieved on day +18 (range, 11-32 days). Sustained platelet counts of more than 20 000/ μL were attained on day +29 (range, 14-98 days). Grades 0-I acute GVHD occurred in 75% of patients. Grades II, III, and IV acute GVHD occurred in 13%, 8%, and 5%, respectively (total grades II-IV GVHD, 26%). Median survival is 366 days (95% CI 185, not estimable) and actuarial survival at 1 year is 52%. Oral sirolimus is tolerable, adequate blood levels are achievable, and there is a low rate of acute GVHD compared with historical data in this high-risk population. This novel agent is worthy of further study in allogeneic transplantation.
Related Links	http://www.bloodjournal.org/content/102/5/1601.full.pdf
Ending Page	1605
Page Count	5
Starting Page	1601
DOI	10.1182/blood-2003-02-0489
Journal	Blood
Issue Number	5
Volume Number	102
Language	English
Publisher	American Society of Hematology
Publisher Date	2003-09-01
Access Restriction	Open
Subject Keyword	Hematology Prophylaxis Antigen Survival Gvhd Donor Methotrexate Tacrolimus Graft Grades Journal: Blood (Vol- 84, Issue- 5)
Content Type	Text
Resource Type	Article

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