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Cytoprotection

A randomized trial of amifostine as a cytoprotectant for patients receiving myeloablative therapy for allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 34, pages 51–56 (2004)Cite this article

Summary:

We initiated a randomized study of amifostine (the organic thiophosphate formerly known as WR-2721) given to patients during myeloablative conditioning therapy for allogeneic bone marrow transplantation. Amifostine was given at a dose of 1000 mg/day of conditioning and was well tolerated if attention was given to serum calcium levels, blood pressure and antiemetics. Since August 1998, 60 patients (30 on each arm) have completed the study. There was no significant difference in the days to neutrophil or platelet engraftment in either arm of the study. Significantly, the duration of grade I–IV mucositis was decreased in the group that received amifostine (P=0.02). Also grade III or IV infections (P=0.008), duration of antibiotic therapy (P=0.03) and duration of fever (P=0.04) were significantly reduced with amifostine. However, there were no differences in the incidence of grade III or IV mucositis, liver toxicity or renal toxicity. There were also no differences in early mortality, relapse and long-term survival. We conclude that amifostine, while reducing the duration of mucositis and infections (possibly through some preservation of gut mucosal integrity), has a modest effect in allogeneic bone marrow transplants given the multiplicity of factors influencing organ toxicity and survival in this setting.

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Acknowledgements

We thank the nursing staff in the Department of Haematology, Singapore General Hospital for excellent nursing care and Schering-Plough Singapore for sponsoring this clinical trial.

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Authors and Affiliations

  1. Department of Haematology, Singapore General Hospital, Outram Road, Singapore, Singapore

    W Y K Hwang, L-P Koh, H J Ng, P H C Tan, C T H Chuah, C Wong, C H Tan & Y-T Goh

  2. Singhealth Research Facilities, Singapore Health Services, Singapore, Singapore

    W Y K Hwang

  3. Department of Clinical Research, Singapore General Hospital, Singapore, Singapore

    S C Fook

  4. Department of Pharmacy, Singapore General Hospital, Singapore, Singapore

    H Chow & K W Tan

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  1. W Y K Hwang
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Correspondence to W Y K Hwang.

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Hwang, W., Koh, LP., Ng, H. et al. A randomized trial of amifostine as a cytoprotectant for patients receiving myeloablative therapy for allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 34, 51–56 (2004). https://doi.org/10.1038/sj.bmt.1704521

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