Palifermin is efficacious in recipients of TBI-based but not chemotherapy-based allogeneic hematopoietic stem cell transplants.

Palifermin is efficacious in recipients of TBI-based but not chemotherapy-based allogeneic hematopoietic stem cell transplants.
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DOI:
10.1038/bmt.2012.115
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发表时间:
2013-01
影响因子:
4.8
通讯作者:
Perales MA
Perales MA
中科院分区:
医学3区
文献类型:
--
作者:
Goldberg JD;Zheng J;Castro-Malaspina H;Jakubowski AA;Heller G;van den Brink MR;Perales MA

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Palifermin是一种重组人角质细胞生长因子,通常用于预防自体移植后的粘膜炎。在异基因造血干细胞移植(allo-HSCT)背景下,安全性和疗效数据有限。我们对251例接受allo-HSCT的患者进行了回顾性研究,其中154例接受了移植物周围Palifermin。在所有患者中,帕利佛明显著减少了全肠外营养(TPN,13 vs 16,p=0.006)和患者自控镇痛(PCA,6 vs 10,p=0.023)的平均天数,以及初始住院时间(LOS,32天vs 37天,p=0.014)。然而,帕利佛明的作用仅在接受TBI但不接受基于白消安的化疗预处理方案的患者中显著。在TBI接受者中,帕利佛明减少了TPN(13 vs 17,p<0.001)和PCA(7 vs 12,p=0.033)的平均天数以及住院时间(32天vs 38天,p=0.001)。帕利弗明不影响移植物抗宿主病、移植物衰竭或复发。因此,在迄今为止对该患者人群进行的最大规模分析中,我们证明了帕利弗明在allo-HSCT患者中是安全的,减少了TPN和PCA的使用,并降低了基于TBI而非基于化疗的allo-HSCT后的LOS。
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 performed 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, p=0.006) and patient-controlled analgesia (PCA, 6 vs 10, p=0.023), and the length of initial hospital stay (LOS, 32 days vs 37 days, p=0.014). However, the effect of palifermin was only significant in patients who received a TBI but not busulfan-based chemotherapy conditioning regimen. In TBI recipients, palifermin decreased the mean number of days of TPN (13 vs 17, p<0.001) and PCA (7 vs 12, p=0.033), and the length of stay (32 days vs 38 days, p=0.001). Palifermin did not affect graft-versus-host disease, 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.
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