Alefacept treatment for refractory chronic extensive GVHD

Shapira, Michael Y.; Abdul-Hai, Ali; Resnick, Igor B.; Bitan, Menachem; Tsirigotis, Panagiotis; Aker, Memet; Gesundheit, Benjamin; Slavin, Shimon; Or, Reuven

doi:10.1038/bmt.2008.324

Cited by 30 publications

(20 citation statements)

References 26 publications

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“…Outras opções estão sendo testadas em estudos fase II e I/II incluindo daclizumab, 59 etarnecept, 60 imatinibe, 61 alefacept, 62 alemtuzumab, 63 pulso de ciclofosfamida, 64 clofazimina, 65 etretinato, 66 pravastatina, 67 budesonida oral 68 e infusão de células-tronco mesenquimais. 69 Pacientes com DECH-c, especialmente aqueles em uso de imunossupressores sistêmicos, devem receber antibióti-co profilático contra bactérias encapsuladas (BIIa); vacinas anti-hemófilos influenza tipo b (Hib conjugada), antipneumocóccica (BIIb) e influenza injetável (BIII); SMX/TMP para prevenir Pneumocystis (AIIa); IGIV quando nível sérico de IgG < 400 mg/dl e infecções sinopulmonares de repetição (CIII); profilaxia antifungo filamentoso em pacientes com infecção fúngica prévia e/ou alto grau de imunossupressão (AIa).…”

Section: Tratamento De Resgateunclassified

Diretrizes para o diagnóstico, classificação, profilaxia e tratamento da doença enxerto contra hospedeiro crônica

Bouzas¹,

Silva²,

Tavares³

et al. 2010

Rev. Bras. Hematol. Hemoter.

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Section: Tratamento De Resgateunclassified

Diretrizes para o diagnóstico, classificação, profilaxia e tratamento da doença enxerto contra hospedeiro crônica

Bouzas¹,

Silva²,

Tavares³

et al. 2010

Rev. Bras. Hematol. Hemoter.

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“…After a median of 8 weeks (8 injections), subjective marked or moderate responses were reported in 5 of 12 patients. 102 The drug was generally well tolerated; however, one patient developed SCC of the lip during the follow-up period-a potentially significant finding, because alefacept is associated with malignancy risk that may be compounded in the setting of concurrent GVHD-related immunosuppression.…”

Section: Mammalian Target Of Rapamycin Inhibitorsmentioning

confidence: 98%

Graft-versus-host disease

Hymes

Alousi

Cowen

2012

Journal of the American Academy of Dermatology

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“…30 Other treatments for BOS have been reported in small series or are currently under investigation, including leukotriene receptor antagonists, extracorporeal photodynamic therapy, antitumor necrosis factor α monoclonal antibodies (such as infliximab), imatinib mesylate, alefacept, daclizumab, and rituximab. [31][32][33][34] In advanced cases, patients may benefit from supplemental oxygen therapy and pulmonary rehabilitation referral. 35 The response to therapy is variable, and the best results of treatment are to maintain lung function and prevent further deterioration.…”

Section: Bronchiolitis Obliterans Syndromementioning

confidence: 99%

Untitled

Diab

ZazaDitYafawi

Soubani³

2016

Exp Clin Transplant

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Both autologous and allogeneic hematopoietic stem cell transplants are important therapeutic options for several benign and malignant disorders. Pulmonary complications, although they have become less frequent, remain a significant cause of morbidity and mortality after hematopoietic stem cell transplant. These complications range from bacterial, fungal, and viral pulmonary infections to noninfectious conditions such as diffuse alveolar hemorrhage and idiopathic pneumonia syndrome. Bronchiolitis obliterans syndrome is the primary chronic pulmonary complication, and treatment of this condition remains challenging. This report highlights the advances in the diagnosis and management of the major pulmonary complications after hematopoietic stem cell transplant. It also underscores the need for prospective and multicenter research to have a better understanding of the mechanisms behind these complications and to obtain more effective diagnostic tool and therapeutic options. Key words: Adverse effects, Lung diseases/etiology, Lung diseases/diagnosis, Respiratory tract infections/etiology, Graft versus host disease IntroductionHematopoietic stem cell transplant (HSCT) is increasingly being used for treatment of a wide range of benign and malignant diseases. About 50 000 to 60 000 HSCTs are done annually. 1 Hematopoietic stem cell transplant can be classified as autologous when the stem cells are harvested from the same patient and reinfused after high-dose chemotherapy, whereas, in allogeneic HSCT, the stem cells are donated by another person. Allogeneic HSCT can be related or unrelated and matched or mismatched. The hematopoietic stem cells might be derived from the bone marrow, umbilical cord, or peripheral blood.Hematopoietic stem cell transplant can be a lifesaving treatment of a wide range of neoplastic and nonneoplastic diseases; however, it is still limited by the development of serious complications. Advances in the preparative regimen using a nonmyeloablative preparative regimen, reduced-intensity conditioning transplants, and posttransplant supportive care have contributed to improved overall survival. Despite these advances, pulmonary complications still occur in about 37% of patient after HSCT 2 and are associated with significant morbidity and mortality. In 1 study, the hazard ratio for death due to pulmonary complications was 30. 1 However, there is evidence that the overall mortality and pulmonary complications after HSCT are improving. A recent review of allogeneic HSCT patients in a large transplant center from 1993 to 2007 showed that the risk of nonrelapse mortality decreased by 60% and overall mortality decreased by 41%. In addition, the risk of acute respiratory failure dropped by 36%, with risk of gram-negative bacterial and invasive mold infections decreasing by 39% and 51%. 3 In this study, we provide an update of the main pulmonary complications (both infectious and noninfectious) after HSCT, including an overview of the diagnostic approach and treatment of these complications. Noninfec...

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Alefacept treatment for refractory chronic extensive GVHD

Cited by 30 publications

References 26 publications

Diretrizes para o diagnóstico, classificação, profilaxia e tratamento da doença enxerto contra hospedeiro crônica

Diretrizes para o diagnóstico, classificação, profilaxia e tratamento da doença enxerto contra hospedeiro crônica

Graft-versus-host disease

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