PMID: 11328304May 1, 2001Paper

Combination therapy with tacrolimus and anti-thymocyte globulin for the treatment of steroid-resistant acute graft-versus-host disease developing during cyclosporine prophylaxis

British Journal of Haematology
P MolleeS Durrant

Abstract

We report our experience with the combination of anti-thymocyte globulin (ATGAM) and tacrolimus in the treatment of 20 patients with steroid refractory and dependent acute graft-versus-host disease (GVHD) transplanted between August 1996 and February 2000. All patients received cyclosporine-based GVHD prophylaxis. Thirteen patients developed a maximum of grade IV, five grade III and two grade II acute GVHD, with 15 patients being refractory to steroids and five dependent on steroids. Patients were treated with ATGAM (15 mg/kg for 5 d) and tacrolimus (0.025--0.1 mg/kg/d) in addition to continuation of their high-dose steroids and cessation of their cyclosporine. Within 28 d of treatment, we observed eight complete responses (CR), six partial responses (PR) and six with no response. Overall response (CR + PR) was predicted by GVHD severity. Infectious complications occurred in 80% of patients. The median survival was 86.5 d (range, 21--1081 d) with 35% of patients remaining alive. Survival following combination therapy was significantly more likely in men (P < 0.001), skin-only GVHD (P = 0.027), less severe GVHD (P = 0.048), and in responders to tacrolimus and ATGAM (P < 0.001). In conclusion, concurrent introduction of ATGAM and...Continue Reading

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Citations

Dec 20, 2002·Clinics in Dermatology·Vincenzo RuoccoRonni Wolf
Jan 25, 2005·American Journal of Clinical Dermatology·Pablo F PeñasAmaro García-Diez
Mar 16, 2007·British Journal of Haematology·Edward S Morris, Geoffrey R Hill
Nov 6, 2015·Indian Journal of Dermatology·Pushpa Kodipalya RamakrishnaiahNataraja Holavanahally Veerabhadrappa
Apr 19, 2012·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Paul J MartinPaul A Carpenter
Jan 5, 2002·Seminars in Cutaneous Medicine and Surgery·J Bergman, M J Rico

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