Thalidomide use in pediatric patients.
OBJECTIVE
To provide a detailed overview of thalidomide use in pediatric patients.


METHODS
English-language articles were identified through a MEDLINE search (1966-February 2001); key terms included thalidomide, child, graft-versus-host disease, cancer, HIV, Crohn's disease, Behçet's disease, and lupus erythematosus. References cited in those articles were also evaluated.


RESULTS
Thalidomide appears to be effective in patients with chronic, not acute, graft-versus-host disease (GVHD) and in healing aphthous ulcers in patients with HIV infection. Limited case reports suggest efficacy of thalidomide in the treatment of cutaneous manifestations of Behçet's disease, Crohn's disease, and lupus in children; however, the recurrence of disease is almost universal on drug discontinuation.


CONCLUSIONS
Thalidomide should be used as a last resort when all other therapies fail, preferably in male or prepubescent female patients.
Bessmertny
Olga
O
Pediatric/Hematology/Oncology/Bone Marrow Transplantation, Columbia Presbyterian Medical Center, New York, NY, USA.
Pham
Trinh
T
D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008297:Male; D016032:Randomized Controlled Trials as Topic; D013281:Stomatitis, Aphthous / Q000188:drug therapy*; D013792:Thalidomide / Q000009:adverse effects / Q000627:therapeutic use
D006993:Hypnotics and Sedatives; D013792:Thalidomide