title: Use of infliximab-daclizumab combination for the treatment of acute and chronic graft-versus-host disease of the liver and gut.
abstract: Infliximab-daclizumab was used to treat acute and chronic liver and gut graft-versus-host disease (GVHD) in two children after standard immunosuppressive therapy failed. Infliximab (10 mg/kg weekly, 4 doses) and daclizumab (1 mg/kg, days 1, 4, 8, 15, and 22) were given over 1 month. In case 1, grade 2 chronic GVHD of the liver developed 1 year after transplantation and failed to improve with tacrolimus, mycophenolate mofetil, and prednisone. In case 2, corticosteroid-unresponsive grade 3 acute liver and gut GVHD developed on day +37. In both patients, GVHD responded to the infliximab-daclizumab regimen without toxicity and immunosuppressive therapy was discontinued.
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. rodriguez.vilmarie@mayo.edu
authors.forename: Vilmarie
authors.initials: V
authors.lastname: Rodriguez
authors.forename: Peter M
authors.initials: PM
authors.lastname: Anderson
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Trotz
authors.forename: Carola A S
authors.initials: CA
authors.lastname: Arndt
authors.forename: Julia A
authors.initials: JA
authors.lastname: Allen
authors.forename: Shakila P
authors.initials: SP
authors.lastname: Khan
mesh_terms: D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D003131:Combined Modality Therapy; D000077561:Daclizumab; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000069285:Infliximab; D053645:Interleukin-2 Receptor alpha Subunit / Q000037:antagonists & inhibitors; D007413:Intestinal Mucosa / Q000473:pathology; D015477:Leukemia, Myelomonocytic, Chronic / Q000188:drug therapy / Q000601:surgery; D008099:Liver / Q000473:pathology; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000601:surgery; D011241:Prednisone / Q000627:therapeutic use; D012008:Recurrence; D012074:Remission Induction; D012086:Reoperation; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use; D014184:Transplantation, Homologous / Q000009:adverse effects; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D053645:Interleukin-2 Receptor alpha Subunit; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000077561:Daclizumab; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus