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1、BoneMarrowTransplantation(2006)37,95–99&2006NaturePublishingGroupAllrightsreserved0268-3369/06$30.00www.nature.com/bmtORIGINALARTICLEDaclizumabforchildrenwithcorticosteroidrefractorygraft-versus-hostdisease121DTTeachey,BBickertandNBunin1DivisionofOncologyintheDepartmentofPediatrics,Childre
2、n’sHospitalofPhiladelphia,UniversityofPennsylvaniaSchoolofMedicine,Philadelphia,PA,USAand2DepartmentofPharmacyServices,Children’sHospitalofPhiladelphia,Philadelphia,PA,USADaclizumab,ahumanizedIL-2receptorantagonist,hasbeenshowntobesafeinchildrenwhenusedtopreventbeenfoundtobesafeandeffectiv
3、einadultswithrejectionaftersolidorgantransplantation.3,4Afewsmallrefractorygraft-versus-hostdisease(GVHD);however,studieshaveshowndaclizumabtobeeffectiveintreatingdatadescribingitsefficacyforrefractoryGVHDinrefractoryacuteandchronicGVHDinadults.2,5–7Threeofchildrenarelimited.Wereportaseries
4、of14childrenwhothesestudiesincludedasmallnumberofchildren;2,6,7weretreatedwithdaclizumabforsevereacuteand/orhowever,resultswerenotstratifiedbyage.Thus,nochroniccorticosteroidrefractoryGVHD.Patientswereconclusionscanbedrawnwithregardtosafetyandefficacytreatedwith2mg/kgweeklyfor8weeksfollowedo
5、fdaclizumabforrefractoryGVHDinpediatrics.by1mg/kgweeklyfor4weeks.Nineof14patientsWeperformedaretrospectivereviewof14patientsrespondedtodaclizumabasmeasuredbyimprovementoftreatedwithdaclizumabafterhematopoieticstemcellGVHDsymptoms,andtheabilitytosubstantiallyweantransplant(HSCT)forGVHDatthe
6、Children’sHospitalcorticosteroiddose.Fiveof11patientswithacuteGVHDofPhiladelphiatoattempttobettercharacterizethehadcompletesymptomresolution,and2/11hadapartialefficacyandtoxicityofthisagentinchildren.response.TwooffourpatientswithchronicGVHDhadcompletesymptomresolution.Inthesepatients,dacli
7、zu-mabwasonlyeffectiveintreatingskinGVHD.SevenofMaterialsandmethodstheninepatientswhohadacompleteorpartialresponseeventuallyhadrecurrenceofGVHD;however,theGVHDPatientsanddosingschedulewaslesssevereandnolongercorticosteroidrefractory.Weidentified14patientswhower