title: Thalidomide treatment for chronic graft-versus-host disease.
abstract: 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.
authors.affiliation: Department of Paediatrics, St James's University Hospital, Leeds.
authors.forename: D
authors.initials: D
authors.lastname: Heney
authors.forename: D R
authors.initials: DR
authors.lastname: Norfolk
authors.forename: J
authors.initials: J
authors.lastname: Wheeldon
authors.forename: C C
authors.initials: CC
authors.lastname: Bailey
authors.forename: I J
authors.initials: IJ
authors.lastname: Lewis
authors.forename: D L
authors.initials: DL
authors.lastname: Barnard
mesh_terms: 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*
chemical_list: D013792:Thalidomide