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Post-Transplant Events

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

Bone Marrow Transplantation volume 48, pages 99–104 (2013)Cite this article

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Abstract

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 conducted 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 days, P=0.006) and patient-controlled analgesia (PCA, 6 vs 10 days, P=0.023), as well as the length of initial hospital stay (LOS, 32 vs 37 days, P=0.014). However, the effect of palifermin was only significant in patients who received a TBI- but not BU-based chemotherapy conditioning regimen. In TBI recipients, palifermin decreased the mean number of days of TPN (13 vs 17 days, P<0.001) and PCA (7 vs 12 days, P=0.033), and the length of stay (32 vs 38 days, P=0.001). Palifermin did not affect GVHD, 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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Acknowledgements

We gratefully acknowledge the expert care provided to these patients by the fellows, housestaff and nurses of Memorial Sloan-Kettering Cancer Center. This study was supported in part by NIH P01 CA23766; research funding was obtained from Swedish Orphan Biovitrium (JDG and M-AP), the Experimental Therapeutics Center of Memorial Sloan-Kettering Cancer Center funded by Mr William H Goodwin and Mrs Alice Goodwin (M-AP), New York Community Trust (M-AP), and Cycle for Survival (M-AP).

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Authors and Affiliations

  1. Department of Medicine, Adult Bone Marrow Transplantation Service, Memorial Sloan-Kettering Cancer Center, NY, USA

    J D Goldberg, H Castro-Malaspina, A A Jakubowski, M R M van den Brink & M-A Perales

  2. Weill Medical College of Cornell University, NY, USA

    J D Goldberg, H Castro-Malaspina, A A Jakubowski, M R M van den Brink & M-A Perales

  3. Department of Epidemiology and Biostatistics; Memorial Sloan-Kettering Cancer Center,

    J Zheng & G Heller

  4. Memorial Sloan-Kettering Cancer Center, NY, USA

    J Zheng & G Heller

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  1. J D Goldberg
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  2. J Zheng
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Correspondence to J D Goldberg.

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Goldberg, J., Zheng, J., Castro-Malaspina, H. et al. Palifermin is efficacious in recipients of TBI-based but not chemotherapy-based allogeneic hematopoietic stem cell transplants. Bone Marrow Transplant 48, 99–104 (2013). https://doi.org/10.1038/bmt.2012.115

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