Thalidomide treatment for chronic graft-versus-host disease.
The treatment of chronic graft-versus-host disease (GVHD) may present a difficult therapeutic problem. We used thalidomide to treat six patients with severe chronic GVHD who failed to respond to standard immunosuppressive agents. Four of the six patients showed a clear response to thalidomide, with the fifth patient showing a partial response. The best results were seen in patients with chronic cutaneous GVHD. Two of the patients developed neurophysiological evidence of a peripheral neuropathy, associated with clinical signs in one patient. Measurement of thalidomide plasma levels and pharmacokinetic curves showed a significant inter-patient variation. Peak plasma levels varied from 0.47 to 1.46 micrograms/ml. Thalidomide has a role to play in the management of chronic GVHD and further studies are needed.
Heney
D
D
Department of Paediatrics, St James's University Hospital, Leeds.
Norfolk
D R
DR
Wheeldon
J
J
Bailey
C C
CC
Lewis
I J
IJ
Barnard
D L
DL
D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D013792:Thalidomide / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*
D013792:Thalidomide