Parker P M, Chao N, Nademanee A, O'Donnell M R, Schmidt G M, Snyder D S, Stein A S, Smith E P, Molina A, Stepan D E, Kashyap A, Planas I, Spielberger R, Somlo G, Margolin K, Zwingenberger K, Wilsman K, Negrin R S, Long G D, Niland J C, Blume K G, Forman S J
Department of Hematology and Bone Marrow Transplantation, City of Hope National Medical Center, Duarte, CA 91010, USA.
Blood. 1995 Nov 1;86(9):3604-9.
Thalidomide has been reported to be an effective agent for treatment of chronic graft-versus-host disease (CGVHD). To determine the efficacy of this agent in patients with refractory CGVHD a total of 80 patients who failed to respond to prednisone (PSE) or PSE and cyclosporine (CSA) were treated with thalidomide. Sixteen patients (20%) had a sustained response, 9 with a complete remission and 7 with a partial response. Twenty-nine patients (36%) had thalidomide discontinued because of side effects, which included sedation, constipation, neuritis, skin rash, and neutropenia. Side effects were reversible with drug discontinuation except for mild residual neuritis in one case. Rashes and neutropenia have not previously been reported as thalidomide side effects when used for CGVHD treatment. We conclude thalidomide is immunosuppressive and active in the treatment of CGVHD. A high incidence of reversible side effects limited dose intensity and reduced the number of patients who could benefit from treatment.
据报道，沙利度胺是治疗慢性移植物抗宿主病（CGVHD）的有效药物。为确定该药物对难治性CGVHD患者的疗效，共有80例对泼尼松（PSE）或PSE与环孢素（CSA）治疗无效的患者接受了沙利度胺治疗。16例患者（20%）获得持续缓解，其中9例完全缓解，7例部分缓解。29例患者（36%）因副作用而停用沙利度胺，副作用包括镇静、便秘、神经炎、皮疹和中性粒细胞减少。除1例有轻度残留神经炎外，停药后副作用均可逆转。皮疹和中性粒细胞减少此前未被报道为沙利度胺用于CGVHD治疗时的副作用。我们得出结论，沙利度胺具有免疫抑制作用，对CGVHD治疗有效。可逆性副作用的高发生率限制了剂量强度，减少了可从治疗中获益的患者数量。
