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Topical thalidomide gel in oral chronic GVHD and role of in situ cytokine expression in monitoring biological activity

Bone Marrow Transplantation volume 48, pages 610–611 (2013)Cite this article

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Data from this paper were presented at the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology 2010 International Symposium, June 24–26, 2010, Vancouver, Canada.

Chronic GVHD (cGVHD) is a major complication for nearly half of allogeneic hematopoietic SCT (HSCT) survivors.1 Chronic GVHD is derived from, and is primarily mediated by, grafted-immunocompetent T cells that proliferate in the recipients and reject host cells as foreign, resulting in multi-organ dysfunction. Approximately 80% of patients with cGVHD have oral involvement characterized by erythema, lichen planus, hyperkeratotic plaques, pseudomembranes and ulcers.2 Oral cGVHD-related pain is reported frequently, and oral dryness has been associated with inferior health-related quality of life. Thalidomide has shown efficacy and safety with minimal systemic absorption for treatment of aphthous stomatitis in HIV (+) patients.3 Here we report preliminary data for topical thalidomide gel in the management of oral ulcerative cGVHD.

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References

  1. Shlomchik WD, Lee SJ, Couriel D, Pavletic SZ . Transplantation's greatest challenges: advances in chronic graft-versus-host disease. Biol Blood Marrow Transplant 2007; 13 (1 Suppl 1): 2–10.

    Article  Google Scholar 

  2. Shulman HM, Kleiner D, Lee SJ, Morton T, Pavletic SZ, Farmer E et al. Histopathologic diagnosis of chronic graft-versus-host disease: National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: II. Pathology Working Group Report. Biol Blood Marrow Transplant 2006; 12: 31–47.

    Article  Google Scholar 

  3. Jacobson JM, Greenspan JS, Spritzler J, Fox L, Fahey JL, Jackson JB et al. Thalidomide in low intermittent doses does not prevent recurrence of human immunodeficiency virus-associated aphthous ulcers. J Infect Dis 2001; 183: 343–346.

    Article  CAS  Google Scholar 

  4. Tsukagoshi S . Action mechanism of thalidomide in treatment of multiple myeloma. Nippon Rinsho 2007; 65: 2291–2295.

    PubMed  Google Scholar 

  5. Sampaio EP, Hernandez MO, Carvalho DS, Sarno EN . Management of erythema nodosum leprosum by thalidomide: thalidomide analogues inhibit M. leprae-induced TNFalpha production in vitro. Biomed Pharmacother 2002; 56: 13–19.

    Article  CAS  Google Scholar 

  6. Wang D, Westerheide SD, Hanson JL, Baldwin AS . Tumor necrosis factor alpha-induced phosphorylation of RelA/p65 on Ser529 is controlled by casein kinase II. J Biol Chem 2000; 275: 32592–32597.

    Article  CAS  Google Scholar 

  7. Lalla RV, Pilbeam CC, Walsh SJ, Sonis ST, Keefe DM, Peterson DE . Role of the cyclooxygenase pathway in chemotherapy-induced oral mucositis: a pilot study. Support Care Cancer 2010; 18: 95–103.

    Article  Google Scholar 

  8. Rhodus NL, Cheng B, Myers S, Miller L, Ho V, Ondrey F . The feasibility of monitoring NF-kappaB associated cytokines: TNF-alpha, IL-1alpha, IL-6, and IL-8 in whole saliva for the malignant transformation of oral lichen planus. Mol Carcinog 2005; 44: 77–82.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This research was funded by the Intramural Research Program, National Institute of Nursing Research, NIH. The authors thank Dr Joan K Austin, Indiana University School of Nursing, Dr Dan Wang, NINR Intramural Research Program and the NINR Writing Group for useful discussions regarding manuscript development. We thank Drs Raymond A Dionne, Sharon M Gordon, and Ron Brown for performing the oral biopsies. We also thank the nursing staff on Outpatient Unit 3 for expert protocol support. The authors also gratefully acknowledge participants of Protocol 04-NR-0069 (clinical trials no. NCT00075023).

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Authors and Affiliations

  1. Intramural Research Program, Symptom Management Branch, National Institute of Nursing Research,

    L St John, T Cozzarelli, E Schroeder & J M Fall-Dickson

  2. National Institutes of Health (NIH), Bethesda, MD, USA

    L St John, T Cozzarelli, E Schroeder & J M Fall-Dickson

  3. University of Maryland, Baltimore College of Dental Surgery, Baltimore, MD, USA

    S M Gordon

  4. Hematology Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA

    R Childs

  5. National Institute of Allergy and Infectious Disease, NIH, Bethesda, MD, USA

    M Marquesen

  6. Experimental Transplantation and Immunology Branch, National Cancer Institute, NIH, Bethesda, MD, USA

    S Z Pavletic

  7. National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA

    T X Wu

  8. NIH Summer Intern Program 2009, University of California, San Diego, CA, USA

    M G Saria

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  1. L St John
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Correspondence to L St John.

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St John, L., Gordon, S., Childs, R. et al. Topical thalidomide gel in oral chronic GVHD and role of in situ cytokine expression in monitoring biological activity. Bone Marrow Transplant 48, 610–611 (2013). https://doi.org/10.1038/bmt.2012.178

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