Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018133 (graft-versus-host disease)
 18,032 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of a prospective randomised trial comparing cyclosporin (CSP) with methotrexate (MTX) as immunosuppressive therapy after HLA-identical sibling marrow transplantation for patients with acute leukemia in first remission were analysed 2.5 years after entry of the last patient into the trial. Patients given cyclosporin showed a faster rate of marrow engraftment, less oro-pharyngeal mucositis, more azotemia and more diastolic hypertension than those receiving methotrexate. Actuarial four-year survival was 69% for patients receiving MTX and 43% for those receiving cyclosporin (not significant). Actuarial four-year survival in continuous complete remission from the time of transplant was 69% and 38% respectively (not significant, p = 0.09). While there was no difference in the incidence or severity of acute or chronic graft-versus-host disease, the actuarial rate of leukemic recurrence was 0% in the MTX and 36% in the GSP group (p = 0.02). This finding emphasises the importance of long-term follow up for the full assessment of new therapeutic protocols of marrow transplantation in the treatment of hematological malignancy.
 ...
PMID:A prospective randomised trial of cyclosporin versus methotrexate after HLA-identical sibling marrow transplantation for patients with acute leukemia in first remission: analysis 2.5 years after last patient entry. 305 5

Beta-1-adrenoreceptor antagonists, Ca(2+) antagonists, and benzodiazepines negatively affect platelet aggregation in vitro. Few data exists on whether platelet function in vivo is relevantly influenced by exposure to any these substances. We analysed in three cohorts of 100 patients each treated with allogeneic hematopoietic stem cell transplantation (HSCT), autologous HSCT, and intensive chemotherapy, respectively, whether treatment with these drugs was associated with an increased risk of bleeding. Cumulative incidences of bleeding in the three cohorts were 47 +/- 5% after allogeneic transplants, 30 +/- 5% after autologous transplant, and 46 +/- 5% after chemotherapy (p = 0.008). Exposure to beta-blockers (hazard ratio [HR] 0.71, p = 0.32), Ca(2+) antagonists (HR 0.90, p = 0.73), and benzodiazepines (HR 1.18, p = 0.29) did not significantly increase the risk of bleeding in any cohort. Instead, bleeding risk was determined by platelet count, presence of inflammation, azotemia, presence of graft-versus-host disease and treatment with low-molecular weight heparin. After correcting for these factors, no differences in bleeding risk were seen between the three cohorts. In conclusion, therapy with Beta-1-adrenoreceptor antagonists, Ca(2+) antagonists, and benzodiazepines did not appear to significantly increase the risk for hemorrhagic complications in patients with iatrogenic severe thrombocytopenia.
 ...
PMID:Effect of beta-blockers, Ca2+ antagonists, and benzodiazepines on bleeding incidence in patients with chemotherapy induced thrombocytopenia. 1992 39