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Titolo:
A multicenter, randomized, double-blind comparison of different doses of intravenous immunoglobulin for prevention of graft-versus-host disease and infection after allogeneic bone marrow transplantation
Autore:
Winston, DJ; Antin, JH; Wolff, SN; Bierer, BE; Small, T; Miller, KB; Linker, C; Kaizer, H; Lazarus, HM; Petersen, FB; Cowan, MJ; Ho, WG; Wingard, JR; Schiller, GJ; Territo, MC; Jiao, J; Petrarca, MA; Tonetta, SA;
Indirizzi:
Univ Calif Los Angeles, Med Ctr, Dept Med, Ctr Hlth Sci, Los Angeles, CA 90095 USA Univ Calif Los Angeles Los Angeles CA USA 90095 Los Angeles, CA 90095 USA Brigham & Womens Hosp, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 mens Hosp, Boston, MA 02115 USA Vanderbilt Univ, Med Ctr, Nashville, TN USA Vanderbilt Univ Nashville TN USA erbilt Univ, Med Ctr, Nashville, TN USA Dana Farber Canc Inst, Boston, MA 02115 USA Dana Farber Canc Inst Boston MA USA 02115 Canc Inst, Boston, MA 02115 USA Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Tufts New England Med Ctr, Boston, MA USA Tufts New England Med Ctr Boston MA USA England Med Ctr, Boston, MA USA Univ Calif San Francisco, Ctr Canc Res, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Univ Calif San Francisco, Dept Pediat, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Rush Presbyterian St Lukes Med Ctr, Chicago, IL 60612 USA Rush Presbyterian St Lukes Med Ctr Chicago IL USA 60612 ago, IL 60612 USA Case Western Reserve Univ Hosp, Cleveland, OH 44106 USA Case Western Reserve Univ Hosp Cleveland OH USA 44106 eland, OH 44106 USA Univ Utah Hosp, Salt Lake City, UT USA Univ Utah Hosp Salt Lake City UT USA v Utah Hosp, Salt Lake City, UT USA St Josephs Hosp, Orange, CA USA St Josephs Hosp Orange CA USASt Josephs Hosp, Orange, CA USA Emory Univ, Ctr Canc, Atlanta, GA 30322 USA Emory Univ Atlanta GA USA 30322 ory Univ, Ctr Canc, Atlanta, GA 30322 USA Alpha Therapeut Corp, Los Angeles, CA USA Alpha Therapeut Corp Los Angeles CA USA rapeut Corp, Los Angeles, CA USA
Titolo Testata:
BONE MARROW TRANSPLANTATION
fascicolo: 2, volume: 28, anno: 2001,
pagine: 187 - 196
SICI:
0268-3369(200107)28:2<187:AMRDCO>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
CYTOMEGALO-VIRUS INFECTION; SERONEGATIVE BLOOD PRODUCTS; IMMUNE GLOBULIN; GANCICLOVIR PROPHYLAXIS; FUNGAL-INFECTIONS; CONTROLLED TRIAL; RECIPIENTS; EFFICACY; COMPLICATIONS; CYCLOSPORINE;
Keywords:
immunoglobulin; graft-versus-host disease; infection;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Winston, DJ Univ Calif Los Angeles, Med Ctr, Dept Med, Ctr Hlth Sci, Room 42-121 CHS, Los Angeles, CA 90095 USA Univ Calif Los Angeles Room 42-121 CHS Los Angeles CA USA 90095
Citazione:
D.J. Winston et al., "A multicenter, randomized, double-blind comparison of different doses of intravenous immunoglobulin for prevention of graft-versus-host disease and infection after allogeneic bone marrow transplantation", BONE MAR TR, 28(2), 2001, pp. 187-196

Abstract

Intravenous immunoglobulin is approved for use in allogeneic bone marrow transplant recipients for prevention of graft-versus-host disease (GVHD) andinfections, but the minimally effective dose has not been established. In this multicenter, randomized, double-blind trial, patients undergoing allogeneic marrow transplantation were randomized to receive 100 mg/kg, 250 mg/kg, or 500 mg/kg doses of intravenous immunoglobulin. Each dose was given weekly for 90 days and then monthly until 1 year after transplant. Six hundred and eighteen patients were evaluated. Acute GVHD (grades 2-4) occurred in39% of the patients (80 of 206) in the 100 mg/kg group, 42% of the patients (88 of 208) in the 250 mg/kg group, and in 35% of the patients (72 of 204) in the 500 mg/kg group (P = 0.344). Among patients with unrelated marrow donors, a higher dose of intravenous immunoglobulin (500 mg/kg) was associated with less acute GVHD (P = 0.07). The incidences of chronic GVHD, infection and interstitial pneumonia were similar for all three doses of intravenous immunoglobulin. The dose of intravenous immunoglobulin also had no effect on the types of infection, relapse of hematological malignancy or survival. Except for more frequent chills (P = 0.007) and headaches (P = 0.015) in patients given the 500 mg/kg or 250 mg/kg dose of immunoglobulin, adverseevents were similar for all three doses. These results suggest that 100 mg/kg, 250 mg/kg, and 500 mg/kg doses of intravenous immunoglobulin are associated with similar incidences of GVHD and infections in most allogeneic marrow transplants. These results should be considered when designing cost-effective strategies for the use of intravenous immunoglobulin in allogeneic marrow transplants receiving other current regimens for prophylaxis of GVHD and infection.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/08/20 alle ore 05:44:36