Wolff, Daniel and Roessler, V. and Steiner, B. and Wilhelm, S. and Weirich, V. and Brenmoehl, Julia and Leithaeuser, M. and Hofmeister, N. and Junghanss, C. and Casper, J. and Hartung, G. and Holler, Ernst and Freund, M. (2005) Treatment of steroid-resistant acute graft-versus-host disease with daclizumab and etanercept. BONE MARROW TRANSPLANTATION, 35 (10). pp. 1003-1010. ISSN 0268-3369, 1476-5365
Full text not available from this repository. (Request a copy)Abstract
Steroid-resistant acute GVHD (aGVHD) following allogeneic hematopoietic stem cell transplantation (alloHSCT) continues to be associated with a high mortality. We report the results of a phase II study of treatment of steroid-resistant aGVHD with the IL-2 receptor antibody daclizumab combined with the TNF-receptor fusion protein etanercept. Treatment consisted of daclizumab 1 mg/kg given i.v. on days 1, 4, 8, 15, 22 and etanercept 16 mg/m(2) s.c. on days 1, 5, 9, 13, 17. A total of 21 patients (age 15-61 years) with steroid-resistant aGVHD after alloHSCT were included in the study. Donor types were HLA-matched related (n=6), HLA-matched unrelated (n=14), and HLA-mismatched unrelated (n=1). Eight patients achieved complete, and six showed partial remission of aGVHD. Seven patients did not respond. Four of 21 patients are currently alive with a median follow-up of 586 (185-1155) days. Three patients died due to relapsed malignancy. Treatment-related mortality was due to infectious complications (n=11) or organ failure due to aGVHD (n=3). In total, 12 patients developed subsequent chronic GVHD. In conclusion, the data demonstrate an acceptable response rate of the combination of daclizumab and etanercept in the treatment of steroid-resistant aGVHD. Nevertheless, long-term mortality due to infectious complications and chronic GVHD remains high.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | STEM-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; RECEPTOR MONOCLONAL-ANTIBODY; REFRACTORY ACUTE; ANTITHYMOCYTE GLOBULIN; ACUTE GVHD; RISK-FACTORS; PNEUMONIA SYNDROME; ALPHA ANTIBODY; INFLIXIMAB; thrombotic thrombocytopenic purpura (TTP); GVHD; daclizumab; etanercept; NOD/CARD15 polymorphism |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 May 2021 07:03 |
| Last Modified: | 14 May 2021 07:03 |
| URI: | https://pred.uni-regensburg.de/id/eprint/36160 |
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