Continuous infusion cyclosporine and nifedipine to day +100 with short methotrexate and steroids as GVHD prophylaxis in unrelated donor transplants

J. L. Liesveld, R. E. Duerst, A. P. Rapoport, L. S. Constine, C. N. Abboud, C. H. Packman, L. A. Wedow, L. Zwetsch, B. McKenna, T. Linder, W. A. Silverman, S. B. Swift, J. M. Rowe, J. F. DiPersio

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6 Scopus citations

Abstract

Unrelated donor marrow transplantation is associated with an increased incidence of graft-versus-host disease (GVHD) compared with sibling donor transplants. Forty-one patients undergoing unrelated donor transplants were treated with a GVHD prophylaxis regimen that consisted of continuous infusion cyclosporine from day -1 to 100 days post transplant along with nifedipine, glucocorticoids and short-course methotrexate. The regimen was well-tolerated in this cohort with mostly high risk disease. Fifty-one percent of patients developed acute GVHD, which was grade III-IV in 22% of patients. Six of 22 patients at risk for chronic GVHD developed extensive chronic GVHD, five of whom were adults. In patients < 18 years of age, there was a > 40% chance of 2 year disease-free survival. Use of continuous infusion cyclosporine with nifedipine as an immunosuppressant and protectant against cyclosporine-induced toxicities in unrelated donor transplants is well-tolerated, and results in acute GVHD incidence favorable to that reported with bolus cyclosporine.

Original languageEnglish
Pages (from-to)511-516
Number of pages6
JournalBone Marrow Transplantation
Volume24
Issue number5
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

Keywords

  • Cyclosporine
  • GVHD
  • Nifedipine
  • Unrelated

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    Liesveld, J. L., Duerst, R. E., Rapoport, A. P., Constine, L. S., Abboud, C. N., Packman, C. H., Wedow, L. A., Zwetsch, L., McKenna, B., Linder, T., Silverman, W. A., Swift, S. B., Rowe, J. M., & DiPersio, J. F. (1999). Continuous infusion cyclosporine and nifedipine to day +100 with short methotrexate and steroids as GVHD prophylaxis in unrelated donor transplants. Bone Marrow Transplantation, 24(5), 511-516. https://doi.org/10.1038/sj.bmt.1701947