Wolff, Daniel and Wilhelm, S. and Hahn, J. and Gentilini, C. and Hilgendorf, I. and Steiner, B. and Kahl, C. and Junghanss, C. and Hartung, G. and Casper, J. and Uharek, L. and Holler, E. and Freund, M. (2006) Replacement of calcineurin inhibitors with daclizumab in patients with transplantation-associated microangiopathy or renal insufficiency associated with graft-versus-host disease. BONE MARROW TRANSPLANTATION, 38 (6). pp. 445-451. ISSN 0268-3369,
Full text not available from this repository. (Request a copy)Abstract
Transplantation-associated microangiopathy(TAM) or renal insufficiency(RI) after allogeneic hematopoietic stem cell transplantation is associated with a high mortality. As calcineurin inhibitors (CI) may contribute to TAM or RI, we evaluated the efficacy of replacing CI by daclizumab in patients with graft-versus-host disease (GVHD). Thirteen patients with GVHD-associated TAM and five patients with RI were treated with daclizumab 1 mg/kg intravenous (i.v.)/week, discontinuation of the CI and continuation of the remaining GVHD treatment. All patients had acute GVHD (steroid-sensitive (n = 4), steroid-refractory(n = 10)) or chronic GVHD (n = 4) and were treated with CI before the start of daclizumab. Nine of 13 patients with TAM treated with daclizumab and discontinuation of CI achieved complete remission of TAM, two had stable disease, and one patient did not respond. Patients receiving daclizumab for RI without TAM showed stabilization (2/5) or improvement (3/5) of renal function. Four of 14 patients with acute GVHD achieved CR, two partial remission, eight patients did not respond and 11/14 died at a median of 39 days after start of the daclizumab. Our data demonstrate that replacement of CI by daclizumab can improve TAM and RI. However, mortality remains high in patients with acute GVHD.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | THROMBOTIC THROMBOCYTOPENIC PURPURA; BONE-MARROW-TRANSPLANTATION; STEM-CELL TRANSPLANTATION; STEROID-REFRACTORY ACUTE; HUMAN ENDOTHELIAL-CELLS; VENOOCCLUSIVE DISEASE; BACTERIAL-ENDOTOXIN; CYCLOSPORINE-A; RISK-FACTORS; T-CELLS; GVHD; transplantation-associated micro-angiopathy; daclizumab; defibrotide; renal insufficiency |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 01 Feb 2021 10:39 |
| Last Modified: | 01 Feb 2021 10:39 |
| URI: | https://pred.uni-regensburg.de/id/eprint/34055 |
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