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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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 (US)
Pages (from-to)511-516
Number of pages6
JournalBone Marrow Transplantation
Volume24
Issue number5
DOIs
StatePublished - 1999

Keywords

  • Cyclosporine
  • GVHD
  • Nifedipine
  • Unrelated

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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