Ch. Cole et al., THALIDOMIDE IN THE MANAGEMENT OF CHRONIC GRAFT-VERSUS-HOST DISEASE INCHILDREN FOLLOWING BONE-MARROW TRANSPLANTATION, Bone marrow transplantation, 14(6), 1994, pp. 937-942
Chronic graft-versus-host disease (GVHD) is the major complication in
patients surviving >100 days postallogeneic bone marrow transplantatio
n and occurs in 30% of pediatric patients. It is most prevalent 1-2 ye
ars post-transplant, Treatment involves corticosteroids and other immu
nosuppressive therapy which may affect growth and increase the likelih
ood of infectious complications. We report five children with severe c
orticosteroid-dependent chronic GVHD treated with thalidomide 12-25 mg
/kg/day. Response to therapy was based on resolution of symptoms of ch
ronic GVHD and withdrawal of other immunosuppressive therapy. All the
children showed clinical response to thalidomide with cessation or dim
inution in other immunosuppressive medication. Side-effects were minim
al and no patient developed peripheral neuropathy. All patients are al
ive 48-65 months post-transplantation. Thalidomide is a safe and effec
tive drug for the treatment of chronic GVHD in children and may avoid
the use of long-term corticosteroid therapy,