title: Palifermin is efficacious in recipients of TBI-based but not chemotherapy-based allogeneic hematopoietic stem cell transplants.
abstract: Palifermin, a recombinant human keratinocyte growth factor, is commonly given to prevent mucositis following autologous transplantation. In the allogeneic hematopoietic stem cell transplant (allo-HSCT) setting, safety and efficacy data are limited. We conducted a retrospective study in 251 patients undergoing allo-HSCT, 154 of whom received peritransplant palifermin. In all patients, palifermin significantly decreased the mean number of days of total parenteral nutrition (TPN, 13 vs 16 days, P=0.006) and patient-controlled analgesia (PCA, 6 vs 10 days, P=0.023), as well as the length of initial hospital stay (LOS, 32 vs 37 days, P=0.014). However, the effect of palifermin was only significant in patients who received a TBI- but not BU-based chemotherapy conditioning regimen. In TBI recipients, palifermin decreased the mean number of days of TPN (13 vs 17 days, P<0.001) and PCA (7 vs 12 days, P=0.033), and the length of stay (32 vs 38 days, P=0.001). Palifermin did not affect GVHD, graft failure or relapse. Therefore, in the largest analysis with this patient population to date, we demonstrate that palifermin is safe in allo-HSCT patients, decreases TPN and PCA use and decreases LOS following TBI-based but not chemotherapy-based allo-HSCT.
authors: Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, NY 10065, USA. goldbej2@mskcc.org
authors: J D
authors: JD
authors: Goldberg
authors: J
authors: J
authors: Zheng
authors: H
authors: H
authors: Castro-Malaspina
authors: A A
authors: AA
authors: Jakubowski
authors: G
authors: G
authors: Heller
authors: M R M
authors: MR
authors: van den Brink
authors: M-A
authors: MA
authors: Perales
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000494:pharmacology; D015331:Cohort Studies; D005260:Female; D051523:Fibroblast Growth Factor 7 / Q000009:adverse effects / Q000235:genetics / Q000627:therapeutic use*; D005500:Follow-Up Studies; D041981:Gastrointestinal Tract / Q000187:drug effects* / Q000503:physiopathology / Q000528:radiation effects; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D009519:New York City / Q000453:epidemiology; D020011:Protective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; C496453:FGF7 protein, human; D020011:Protective Agents; D011994:Recombinant Proteins; D051523:Fibroblast Growth Factor 7