沙利度胺在慢性难治性移植物抗宿主病中的应用。
The use of thalidomide in chronic refractory graft versus host disease.
作者信息
van de Poel M H, Pasman P C, Schouten H C
机构信息
Department of Internal Medicine, Academic Hospital Maastricht, Postbus 5800, 6202 AZ Maastricht, The Netherlands.
出版信息
Neth J Med. 2001 Aug;59(2):45-9. doi: 10.1016/s0300-2977(01)00133-4.
BACKGROUND
Chronic graft versus host disease (GvHD) is a serious complication of allogenic bone marrow transplantation. As prednisone and ciclosporine A are not always effective in its treatment, we investigated the value of thalidomide.
METHODS
We describe the results of thalidomide in 12 patients with chronic prednison/ciclosporin A refractory GvHD seen in our clinic since 1991. A case history is given as illustration.
RESULTS
Four patients had a complete remission of chronic GvHD on thalidomide; five patients showed a partial response. Of these five patients, three died eventually of respectively ongoing GvHD, pneumonia and recurrent leukemia. There were no serious side effects, except for one patient who had to stop thalidomide because of polyneuropathy.
CONCLUSIONS
It is worthwhile to give thalidomide in prednison/ciclosporin A refractory chronic GvHD. Probably thalidomide should be given earlier in the course of GvHD, this needs further study.
背景
慢性移植物抗宿主病（GvHD）是同种异体骨髓移植的一种严重并发症。由于泼尼松和环孢素A对其治疗并非总是有效，我们研究了沙利度胺的价值。
方法
我们描述了自1991年以来在我们诊所中12例慢性泼尼松/环孢素A难治性GvHD患者使用沙利度胺的结果。给出一个个案史作为例证。
结果
4例患者使用沙利度胺后慢性GvHD完全缓解；5例患者有部分反应。在这5例患者中，3例最终分别死于持续的GvHD、肺炎和复发性白血病。除1例因多发性神经病不得不停用沙利度胺的患者外，无严重副作用。
结论
在泼尼松/环孢素A难治性慢性GvHD中给予沙利度胺是值得的。可能沙利度胺应在GvHD病程中更早给予，这需要进一步研究。
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