title: Thalidomide for treatment of patients with chronic graft-versus-host disease.
abstract: In a randomized, placebo-controlled, double-blind trial, thalidomide or placebo together with glucocorticoids and either cyclosporine or tacrolimus was administered as initial therapy for clinical extensive chronic graft-versus-host disease (cGVHD). All patients had thrombocytopenia or cGVHD that evolved directly from acute GVHD as an indicator of a poor prognosis. The study drug (thalidomide or placebo) was administered initially at a dose of 200 mg orally per day, followed by a gradual increase to 800 mg/d if side effects were tolerable. Treatment with the study drug was discontinued before resolution of cGVHD in 23 (92%) of the 25 patients who received thalidomide and in 17 (65%) of the 26 patients who received placebo (P =.02). Neutropenia and neurologic symptoms were the most frequent reasons for early discontinuation of treatment with thalidomide. The duration of treatment with thalidomide was too short to assess its efficacy in controlling cGVHD. (Blood. 2000;96:3995-3996)
authors.affiliation: Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
authors.forename: S
authors.initials: S
authors.lastname: Koc
authors.forename: W
authors.initials: W
authors.lastname: Leisenring
authors.forename: M E
authors.initials: ME
authors.lastname: Flowers
authors.forename: C
authors.initials: C
authors.lastname: Anasetti
authors.forename: H J
authors.initials: HJ
authors.lastname: Deeg
authors.forename: R A
authors.initials: RA
authors.lastname: Nash
authors.forename: J E
authors.initials: JE
authors.lastname: Sanders
authors.forename: R P
authors.initials: RP
authors.lastname: Witherspoon
authors.forename: F R
authors.initials: FR
authors.lastname: Appelbaum
authors.forename: R
authors.initials: R
authors.lastname: Storb
authors.forename: P J
authors.initials: PJ
authors.lastname: Martin
mesh_terms: D000206:Actuarial Analysis; D002908:Chronic Disease; D016572:Cyclosporine / Q000008:administration & dosage / Q000633:toxicity; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006086:Graft vs Host Disease / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006987:Hypesthesia / Q000139:chemically induced; D009503:Neutropenia / Q000139:chemically induced; D011241:Prednisone / Q000008:administration & dosage / Q000633:toxicity; D013792:Thalidomide / Q000008:administration & dosage* / Q000633:toxicity
chemical_list: D013792:Thalidomide; D016572:Cyclosporine; D011241:Prednisone