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Daclizumab has poor efficacy in steroid-refractory severe acute graft-versus-host disease: a single centre experience with 12 allograft patients

Bone Marrow Transplantation volume 41, pages 409–410 (2008)Cite this article

Steroid-refractory acute graft-versus-host-disease (aGVHD) carries a poor prognosis. Daclizumab, a humanized monoclonal anti-interleukin-2 receptor antibody, has been tried in patients with steroid-refractory aGVHD, with the rationale that it may deplete allo-reactive T cells and modulate the severity of aGVHD while allowing a greater subsequent immunologic recovery than a nonselective pan-T-cell antibody. Reported outcomes, however, were conflicting.1, 2, 3, 4, 5

We performed a retrospective review of the outcome of 12 consecutive allograft patients who had been treated with daclizumab for steroid-refractory (defined as ⩾2 mg/kg per day of i.v. methylprednisolone for ⩾3 days), grade III–IV aGVHD in our transplant unit. All patients had received standard GVHD prophylaxis using CYA and MTX (except patient 1 due to the absence of GVHD in a previous transplant). They were also given standard antimicrobial prophylaxis and pre-emptively monitored against CMV. Clinical grading of biopsy-confirmed aGVHD was performed according to standard criteria. Daclizumab was given at a dose of 1 mg/kg i.v. on days 1, 4, 8, 15 and 22. Treatment response at day 43 of aGVHD was defined according to Przepiorka et al.1 (complete response if stage 0 achieved; partial response if a reduction in at least one stage in an organ without deterioration in the other organs).

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References

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Authors and Affiliations

  1. Institute of Medical and Veterinary Science, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    C H Hui, H Sia, H Mangos, N Horvath, H Lee, I Lewis, T Hughes, L B To & P Bardy

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  1. C H Hui
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  2. H Sia
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  3. H Mangos
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  4. N Horvath
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  5. H Lee
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  6. I Lewis
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  7. T Hughes
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  8. L B To
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  9. P Bardy
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Correspondence to C H Hui.

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Hui, C., Sia, H., Mangos, H. et al. Daclizumab has poor efficacy in steroid-refractory severe acute graft-versus-host disease: a single centre experience with 12 allograft patients. Bone Marrow Transplant 41, 409–410 (2008). https://doi.org/10.1038/sj.bmt.1705927

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