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Continuous infusion cyclosporine and nifedipine to day +100 with short methotrexate and steroids as GVHD prophylaxis in unrelated donor transplants.

作者信息

Liesveld J, Duerst R, Rapoport A, Constine L, Abboud C, Packman C, Wedow L, Zwetsch L, McKenna B, Linder T, Silverman W, Swift S, Rowe J, DiPersio J

机构信息

Department of Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA.

出版信息

Bone Marrow Transplant. 1999 Sep;24(5):511-6. doi: 10.1038/sj.bmt.1701947.

Abstract

Unrelated donor marrow transplantation is associated with an increased incidence of graft-versus-host disease (GVHD) compared with sibling donor transplants. Forty-one patients undergoing unrelated donor transplants were treated with a GVHD prophylaxis regimen that consisted of continuous infusion cyclosporine from day -1 to 100 days post transplant along with nifedipine, glucocorticoids and short-course methotrexate. The regimen was well-tolerated in this cohort with mostly high risk disease. Fifty-one percent of patients developed acute GVHD, which was grade III-IV in 22% of patients. Six of 22 patients at risk for chronic GVHD developed extensive chronic GVHD, five of whom were adults. In patients <18 years of age, there was a >40% chance of 2 year disease-free survival. Use of continuous infusion cyclosporine with nifedipine as an immunosuppressant and protectant against cyclosporine-induced toxicities in unrelated donor transplants is well-tolerated, and results in acute GVHD incidence favorable to that reported with bolus cyclosporine.

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