FK 506 rescue in chronic graft-versus-host-disease after bone marrow transplantation.

Abstract

C HRONIC graft-versus-host-disease (GVHD) is a de- bilitating and often fatal complication seen in 30% to 60% of patients undergoing allogeneic bone marrow transplantation (BMT).'Its prognosis is poorer with advancing patient age, when it is extensive.if it appears progressively after acute GVHO, if total bilirubin is more than 1.2 mg/dL, or if the platelet count is less than lOO.OOO/mL.Conventional treatment includes combination immunosuppression most often with cyclosporine (CyA) and prednisone.Azathioprine.methotrexate.antilymphocyte globulin.and other therapies may also be used.l~ FK 506 is a potent new immunosuppressive agent effective in rescue of solid organ transplant patients who failed conventional treatment for immunologically mediated damage. 7e attempted rescue of patients with severe chronic GVHO after BMT who had failed conventional treatment.