Lawitschka, Anita and Lucchini, Giovanna and Strahm, Brigitte and Dalle, Jean-Hugues and Balduzzi, Adriana and Gibson, Brenda and Diaz De Heredia, Cristina and Wachowiak, Jacek and Dalissier, Arnaud and Vettenranta, Kim and Yaniv, Isaac and Bordon, Victoria and Bauer, Dorothea and Bader, Peter and Meisel, Roland and Peters, Christina and Corbacioglu, Selim (2020) Pediatric acute graft-versus-host disease prophylaxis and treatment: surveyed real-life approach reveals dissimilarities compared to published recommendations. TRANSPLANT INTERNATIONAL, 33 (7). pp. 762-772. ISSN 0934-0874, 1432-2277
Full text not available from this repository. (Request a copy)Abstract
Pediatric allogeneic hematopoietic cell transplantation (HCT) practices differ from those of adults, particularly the heterogeneity of transplantable nonmalignant diseases and the lower incidence of graft-versus-host disease (GVHD). Several guidelines regarding the management of acute (a) GVHD in adult HCT have been published. We aimed to capture the real-life approaches for pediatric aGVHD prophylaxis/treatment, and data from 75/193 (response rate 39%) EBMT centers (26 countries) were included, representing half (48%) of the pediatric EBMT-HCT activity. Results with >= 75% approval from respondents (74/75) for GVHD prophylaxis after myeloablative HCT for malignancies partially contradict published guidelines: Single-agent cyclosporine A (CsA) was used for matched sibling donor HCT in 47%; blood CsA levels were reported lower; the relapse risk in malignant diseases influenced GVHD prophylaxis with early withdrawal of CsA; distinct longer duration of CsA was employed in nonmalignant diseases. Most centers used additional anti-thymocyte globulin for matched unrelated and mismatched donor HCT, but not for matched siblings. Regarding prophylaxis in nonmyeloablative conditioning (mainly for nonmalignant diseases), responses showed broad heterogeneity. High conformity was found for first-line treatment; however, results regarding steroid-refractory aGVHD indicate an earlier diagnosis in children. Our findings highlight the need for standardized pediatric approaches toward aGVHD prophylaxis/treatment differentiated for malignant and nonmalignant underlying diseases.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | STEM-CELL TRANSPLANTATION; EXTRACORPOREAL PHOTOPHERESIS; MARROW-TRANSPLANTATION; MYCOPHENOLATE-MOFETIL; CENTER STRATEGIES; EUROPEAN GROUP; ACUTE-LEUKEMIA; ACUTE GVHD; CHILDREN; BLOOD; acute GVHD; hematopoietic cell transplantation; pediatrics; prophylaxis; treatment |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Pädiatrische Hämatologie, Onkologie und Stammzelltransplantation |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Mar 2021 04:11 |
| Last Modified: | 29 Mar 2021 04:11 |
| URI: | https://pred.uni-regensburg.de/id/eprint/44777 |
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