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Hydroxychloroquine for the prevention of acute graft-versus-host disease after unrelated donor transplantation. Biol Blood Marrow Transplant 2003 Nov;9(11):714-21 PMID: 14652855

Pubmed ID

14652855

Abstract

Hydroxychloroquine (HCQ) is an immunosuppressive agent that interferes with antigen presentation and with activity against graft-versus-host disease (GVHD). In a phase II trial assessing the GVHD prophylactic effects of HCQ, 51 consecutive unrelated donor transplant recipients received HCQ in addition to cyclosporin A, methylprednisolone, and methotrexate. HCQ was initiated on pretransplantation day -21 at 800 mg/d and continued until day +100 after transplantation. HCQ was extremely well tolerated and was not associated with side effects. Pharmacokinetic analyses demonstrated large inter- and intrapatient variability. The addition of HCQ did not affect posttransplantation immune recovery. Grade II to IV acute GVHD was observed in 56% of patients, and grade III and IV GVHD was observed in 17%. Day +100 mortality was 22%. When compared with a matched cohort of patients reported to the International Bone Marrow Transplant Registry, patients receiving HCQ had comparable cumulative incidences of grade II to IV acute GVHD. However, lower incidences of grades III and IV GVHD and better GVHD-free survival were observed in HCQ-treated patients (P =.01). We conclude that prophylactic HCQ is well tolerated and associated with a low incidence of severe acute GVHD. An ongoing placebo-controlled randomized trial will further determine what role HCQ plays in preventing GVHD after allografting.

Author List

Khoury H, Trinkaus K, Zhang MJ, Adkins D, Brown R, Vij R, Goodnough LT, Ma MK, McLeod HL, Shenoy S, Horowitz M, Dipersio JF

Authors

Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-9144224186   21 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Antigens, CD
Bone Marrow Transplantation
Cause of Death
Enzyme Inhibitors
Graft vs Host Disease
Hematologic Neoplasms
Humans
Hydroxychloroquine
Incidence
Living Donors
Lymphocyte Subsets
Middle Aged
Neoplasms
Retrospective Studies
Tissue Donors
Transplantation Chimera
Transplantation Conditioning
jenkins-FCD Prod-332 f92a19b0ec5e8e1eff783fac390ec127e367c2b5