Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Drug therapy for acute graft-versus-host disease prophylaxis
Autore:
Simpson, D;
Indirizzi:
Rush Presbyterian St Lukes Med Ctr, Sect Bone Marrow Transplant & Cell Therapy, Chicago, IL 60612 USA Rush Presbyterian St Lukes Med Ctr Chicago IL USA 60612 ago, IL 60612 USA
Titolo Testata:
JOURNAL OF HEMATOTHERAPY & STEM CELL RESEARCH
fascicolo: 3, volume: 9, anno: 2000,
pagine: 317 - 325
SICI:
1525-8165(200006)9:3<317:DTFAGD>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MARROW TRANSPLANTATION; TERM FOLLOW-UP; RENAL-ALLOGRAFT REJECTION; SEVERE APLASTIC-ANEMIA; HUMAN T-LYMPHOCYTES; MYCOPHENOLATE MOFETIL; IMMUNOSUPPRESSANT 15-DEOXYSPERGUALIN; KIDNEY-TRANSPLANTATION; MINIDOSE METHOTREXATE; SIGNAL-TRANSDUCTION;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
77
Recensione:
Indirizzi per estratti:
Indirizzo: Simpson, D Rush Presbyterian St Lukes Med Ctr, Sect Bone Marrow Transplant& Cell Therapy, 1653 W Congress Pkwy, Chicago, IL 60612 USA Rush Presbyterian St Lukes Med Ctr 1653 W Congress Pkwy Chicago IL USA 60612
Citazione:
D. Simpson, "Drug therapy for acute graft-versus-host disease prophylaxis", J HEMATH ST, 9(3), 2000, pp. 317-325

Abstract

The mechanisms of many immunosuppressive drugs have been defined, allowingfor a rational aproach to the use of these agents in GVHD prophylaxis. In addition to standard drugs such as methotrexate, cyclosporine, tacrolimus, and glucocorticoids, new agents-mycophenolate mofetil, tresperimus, rapamycin, basiliximab, and daclizumab-are now part of the immunosuppressive armamentarium. Improved understanding of tolerance has resulted in new approaches to prevention of GVHD. Anti-CD40L, CTLA-4-Ig, tresperimus, and rapamycin are agents that are being explored in this area and have shown impressive results in animal models. Currently, the standard therapy for acute GVHD prophylaxis in matched sibling transplants remains cyclosporine and methotrexate. Lower dose methotrexate, particularly in combination with tacrolimus, has shown good results insingle arm studies with low toxicity, but this has not been tested in a randomized study. For unrelated donor transplants there is less GVHD when tacrolimus, rather than cyclosporine, is combined with methotrexate; there seems little reason to use cyclosporine in this setting. GVHD is still the major barrier to more widespread use of unrelated donor transplants and improved regimens are needed. In vivo T-cell depletion using Campath-1 or ATG is being used in high-risk patients. Data on its efficacy are so far anecdotal. Due to the variation in grading of GVHD between centers, randomized studies are needed to quantify the relative merits of different regimens, and participation in such studies is encouraged.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 10:38:56