PMID- 20827187
OWN - NLM
STAT- MEDLINE
DCOM- 20110222
LR  - 20211020
IS  - 1531-7048 (Electronic)
IS  - 1065-6251 (Print)
IS  - 1065-6251 (Linking)
VI  - 17
IP  - 6
DP  - 2010 Nov
TI  - High-dose cyclophosphamide for graft-versus-host disease prevention.
PG  - 493-9
LID - 10.1097/MOH.0b013e32833eaf1b [doi]
AB  - PURPOSE OF REVIEW: Administration of high-dose cyclophosphamide after 
      transplantation inhibits both graft rejection and graft-versus-host disease 
      (GvHD) in mouse models of allogeneic blood or marrow transplantation (alloBMT). 
      This strategy has recently been adapted to human transplantation. RECENT 
      FINDINGS: The safety and efficacy of high-dose posttransplantation 
      cyclophosphamide, when given in combination with tacrolimus and mycophenolate 
      mofetil, was first demonstrated after nonmyeloablative conditioning and 
      allografting using human leukocyte antigen (HLA)-mismatched related donors. 
      Further analysis shows that increasing HLA disparity does not worsen overall 
      outcome. High-dose posttransplantation cyclophosphamide was also found to be 
      effective as sole prophylaxis of acute and chronic GvHD after HLA-matched 
      alloBMT. SUMMARY: Taking advantage of the differential susceptibility of 
      proliferating, alloreactive T cells over nonproliferating, nonalloreactive T 
      cells to high-dose cyclophosphamide, and owing to the drug's stem cell sparing 
      effects, this novel strategy provides a unique opportunity to optimize GvHD 
      prophylaxis after HLA-matched alloBMT and increase the use of HLA-mismatched 
      related donors. Well tolerated and effective mismatched related alloBMT provides 
      access to essentially everyone, such as patients with sickle cell anemia, in need 
      of the procedure.
FAU - Luznik, Leo
AU  - Luznik L
AD  - Sidney Kimmel Comprehensive Cancer Center and Department of Oncology, Johns 
      Hopkins University School of Medicine, Baltimore, Maryland 21231, USA. 
      luznile@jhmi.edu
FAU - Jones, Richard J
AU  - Jones RJ
FAU - Fuchs, Ephraim J
AU  - Fuchs EJ
LA  - eng
GR  - P01 CA015396/CA/NCI NIH HHS/United States
GR  - R01 CA122779/CA/NCI NIH HHS/United States
GR  - R01 HL110907/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Review
PL  - United States
TA  - Curr Opin Hematol
JT  - Current opinion in hematology
JID - 9430802
RN  - 0 (Immunosuppressive Agents)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Animals
MH  - Bone Marrow Transplantation/immunology
MH  - Cyclophosphamide/*therapeutic use
MH  - Disease Models, Animal
MH  - Graft Rejection/immunology
MH  - Graft vs Host Disease/*prevention & control
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Mice
PMC - PMC3138214
MID - NIHMS287514
EDAT- 2010/09/10 06:00
MHDA- 2011/02/23 06:00
PMCR- 2011/11/01
CRDT- 2010/09/10 06:00
PHST- 2010/09/10 06:00 [entrez]
PHST- 2010/09/10 06:00 [pubmed]
PHST- 2011/02/23 06:00 [medline]
PHST- 2011/11/01 00:00 [pmc-release]
AID - 10.1097/MOH.0b013e32833eaf1b [doi]
PST - ppublish
SO  - Curr Opin Hematol. 2010 Nov;17(6):493-9. doi: 10.1097/MOH.0b013e32833eaf1b.