High-dose cyclophosphamide as single-agent, short-course prophylaxis of graft-versus-host disease
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- Leo Luznik
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Javier Bolaños-Meade
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Marianna Zahurak
- Departments of Biostatistics and
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- Allen R. Chen
- Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
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- B. Douglas Smith
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Robert Brodsky
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Carol Ann Huff
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Ivan Borrello
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- William Matsui
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Jonathan D. Powell
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Yvette Kasamon
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Steven N. Goodman
- Departments of Biostatistics and
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- Allan Hess
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Hyam I. Levitsky
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Richard F. Ambinder
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Richard J. Jones
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
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- Ephraim J. Fuchs
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology and
説明
<jats:title>Abstract</jats:title><jats:p>Because of its potent immunosuppressive yet stem cell–sparing activity, high-dose cyclophosphamide was tested as sole prophylaxis of graft-versus-host disease (GVHD) after myeloablative allogeneic bone marrow transplantation (alloBMT). We treated 117 patients (median age, 50 years; range, 21-66 years) with advanced hematologic malignancies; 78 had human leukocyte antigen (HLA)–matched related donors and 39 had HLA-matched unrelated donors. All patients received conventional myeloablation with busulfan/cyclophosphamide (BuCy) and T cell–replete bone marrow followed by 50 mg/kg/d of cyclophosphamide on days 3 and 4 after transplantation. The incidences of acute grades II through IV and grades III through IV GVHD for all patients were 43% and 10%, respectively. The nonrelapse mortality at day 100 and 2 years after transplantation were 9% and 17%, respectively. The actuarial overall survival and event-free survivals at 2 years after transplantation were 55% and 39%, respectively, for all patients and 63% and 54%, respectively, for patients who underwent transplantation while in remission. With a median follow-up of 26.3 months among surviving patients, the cumulative incidence of chronic GVHD is 10%. These results suggest that high-dose posttransplantation cyclophosphamide is an effective single-agent prophylaxis of acute and chronic GVHD after BuCy conditioning and HLA-matched BMT (clinicaltrials.gov no. NCT00134017).</jats:p>
収録刊行物
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- Blood
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Blood 115 (16), 3224-3230, 2010-04-22
American Society of Hematology