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- Title
The impact of cyclosporin A on acute graft-versus-host disease after allogeneic bone marrow transplantation in children and adolescents with acute lymphoblastic leukemia.
- Authors
Teuffel, O.; Schrauder, A.; Sykora, K. W.; Zimmermann, M.; Reiter, A.; Welte, K.; Schrappe, M.
- Abstract
Summary:Experimental and clinical data demonstrate an antileukemia effect of acute graft-versus-host disease (aGVHD). In all, 58 pediatric patients with acute lymphoblastic leukemia (ALL) who had received an allogeneic bone marrow transplant (BMT) at our institution were retrospectively analyzed for a correlation between the development of aGVHD and leukemic relapse. Probability of relapse after 5 (3) years was 13% (7%) in patients developing grade II–IV aGVHD vs 30% in patients with grade 0 or I aGVHD. There was a trend for a difference of the point estimates at 3 years, but no overall significance because of an unusual late relapse. Moreover, we analyzed the impact of cyclosporin A (CsA) on aGVHD in a subgroup of 22 children who had received a matched sibling donor (MSD) BMT. An increased dose of CsA within the first 2 weeks after BMT led to decreased occurrence and severity of aGVHD (P=0.035). The cumulative CsA dose appeared to have more impact than the average CsA whole-blood levels within the first 2 weeks and than the CsA dose given from day 15 to 40. In this subgroup, no life-threatening aGVHD or death from aGVHD occurred. In all cases (6/22), leukemic relapse was the cause of death. We therefore suggest that there is a relation between dose of CsA and relapse rate in childhood ALL transplanted from a MSD.Bone Marrow Transplantation (2005) 36, 145–150. doi:10.1038/sj.bmt.1705010 Published online 23 May 2005
- Subjects
CYCLOSPORINE; CYCLIC peptides; IMMUNOSUPPRESSIVE agents; BONE marrow transplantation; JUVENILE diseases; LYMPHOBLASTIC leukemia
- Publication
Bone Marrow Transplantation, 2005, Vol 36, Issue 2, p145
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/sj.bmt.1705010