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Treatment of human acute graft-versus-host disease with antithymocyte globulin and cyclosporine with or without methylprednisolone.

Publication ,  Journal Article
Deeg, HJ; Loughran, TP; Storb, R; Kennedy, MS; Sullivan, KM; Doney, K; Appelbaum, FR; Thomas, ED
Published in: Transplantation
August 1985

Forty-eight patients with hematologic malignancies treated by allogeneic marrow transplantation developed acute graft-versus-host disease (GVHD), grades II-IV, despite prophylaxis with methotrexate. They were treated with a combination of antithymocyte globulin (ATG) and cyclosporine (CsA), with or without the addition of methylprednisolone (MP). Thirty patients had received HLA-identical and 18 HLA-nonidentical transplants. Median onset of GVHD was day 13 (range 8-60) for patients with HLA-nonidentical grafts and day 18 (range 7-48) for patients given HLA-identical grafts (P = 0.01). Forty-five patients could be evaluated for response on day 7 of therapy. Among these, 13 of 27 given ATG/CSP and 6 of 18 given ATG/CSP/MP improved. Among 33 patients evaluable on day 14 of therapy 13 of 19 given ATG/CSP and 5 of 14 given ATG/CSP/MP showed improvement of GVHD. Patients given HLA-nonidentical grafts responded somewhat (although not significantly) less frequently than patients given HLA-identical grafts. Chronic GVHD developed in 16 of 18 evaluable patients given ATG/CSP and in 5 of 6 given ATG/CSP/MP. Viral, bacterial, and fungal infections were the major cause of death in both groups. Interstitial pneumonitis was more frequent among patients given ATG/CSP/MP. Survival beyond 6 months was 67% among patients treated with ATG/CSP and 25% with ATG/CSP/MP. These data indicate that a regimen of ATG/CSP is of value in the treatment of acute GVHD. The addition of MP was not beneficial and resulted in decreased survival--presumably because of excessive immunosuppression and associated complications.

Duke Scholars

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

August 1985

Volume

40

Issue

2

Start / End Page

162 / 166

Location

United States

Related Subject Headings

  • Surgery
  • Pulmonary Fibrosis
  • Methylprednisolone
  • Male
  • Humans
  • Graft vs Host Disease
  • Female
  • Drug Therapy, Combination
  • Cyclosporins
  • Clinical Trials as Topic
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Deeg, H. J., Loughran, T. P., Storb, R., Kennedy, M. S., Sullivan, K. M., Doney, K., … Thomas, E. D. (1985). Treatment of human acute graft-versus-host disease with antithymocyte globulin and cyclosporine with or without methylprednisolone. Transplantation, 40(2), 162–166. https://doi.org/10.1097/00007890-198508000-00011
Deeg, H. J., T. P. Loughran, R. Storb, M. S. Kennedy, K. M. Sullivan, K. Doney, F. R. Appelbaum, and E. D. Thomas. “Treatment of human acute graft-versus-host disease with antithymocyte globulin and cyclosporine with or without methylprednisolone.Transplantation 40, no. 2 (August 1985): 162–66. https://doi.org/10.1097/00007890-198508000-00011.
Deeg HJ, Loughran TP, Storb R, Kennedy MS, Sullivan KM, Doney K, et al. Treatment of human acute graft-versus-host disease with antithymocyte globulin and cyclosporine with or without methylprednisolone. Transplantation. 1985 Aug;40(2):162–6.
Deeg, H. J., et al. “Treatment of human acute graft-versus-host disease with antithymocyte globulin and cyclosporine with or without methylprednisolone.Transplantation, vol. 40, no. 2, Aug. 1985, pp. 162–66. Pubmed, doi:10.1097/00007890-198508000-00011.
Deeg HJ, Loughran TP, Storb R, Kennedy MS, Sullivan KM, Doney K, Appelbaum FR, Thomas ED. Treatment of human acute graft-versus-host disease with antithymocyte globulin and cyclosporine with or without methylprednisolone. Transplantation. 1985 Aug;40(2):162–166.

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

August 1985

Volume

40

Issue

2

Start / End Page

162 / 166

Location

United States

Related Subject Headings

  • Surgery
  • Pulmonary Fibrosis
  • Methylprednisolone
  • Male
  • Humans
  • Graft vs Host Disease
  • Female
  • Drug Therapy, Combination
  • Cyclosporins
  • Clinical Trials as Topic