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Thalidomide as salvage therapy for chronic graft-versus-host disease
PM Parker, N Chao, A Nademanee, MR O'Donnell, GM Schmidt, DS Snyder, AS Stein, EP Smith, A Molina and DE Stepan
Department of Hematology and Bone Marrow Transplantation, City of Hope
National Medical Center, Duarte, CA 91010, USA.
Thalidomide has been reported to be an effective agent for treatment of
chronic graft-versus-host disease (CGVHD). To determine the efficacy of
this agent in patients with refractory CGVHD a total of 80 patients who
failed to respond to prednisone (PSE) or PSE and cyclosporine (CSA) were
treated with thalidomide. Sixteen patients (20%) had a sustained response,
9 with a complete remission and 7 with a partial response. Twenty-nine
patients (36%) had thalidomide discontinued because of side effects, which
included sedation, constipation, neuritis, skin rash, and neutropenia. Side
effects were reversible with drug discontinuation except for mild residual
neuritis in one case. Rashes and neutropenia have not previously been
reported as thalidomide side effects when used for CGVHD treatment. We
conclude thalidomide is immunosuppressive and active in the treatment of
CGVHD. A high incidence of reversible side effects limited dose intensity
and reduced the number of patients who could benefit from treatment.
Volume 86,
Issue 9,
pp. 3604-3609,
11/01/1995
Copyright © 1995 by The American Society of Hematology
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