for madubois63--as you said you suffered from graft vs host disease in another thread

[Lani]

Pentostatin Promising in Graft-Versus-Host Disease


NEW YORK (Reuters Health) Oct 11 - The adenosine deaminase inhibitor pentostatin, which is active against acute graft-versus-host disease (GVHD), also appears to be effective in chronic refractory GVHD, according to the results of a new study.

As senior investigator Dr. Georgia B. Vogelsang told Reuters Health, "this study suggests that pentostatin is useful in the treatment of chronic GVHD that has not responded to steroids."

There is no standard treatment for patients with chronic disease who have failed corticosteroid therapy, Dr. Vogelsang of Johns Hopkins University School of Medicine in Baltimore and colleagues note In the September 20th issue of the Journal of Clinical Oncology.

To investigate the efficacy of pentostatin, the researchers studied 58 patients with refractory disease who had undergone treatment with several prior regimens for about 20 months.

Corticosteroid taper was begun after three doses of pentostatin, which was administered intravenously every 2 weeks. Therapy continued as long as benefit was documented.

A total of 32 patients (55%) showed a response, which was considered to be major in all but one patient. The responders received from 1 to 32 doses of pentostatin (median 12 doses).

Survival was 78% at 1 year and 70% at 2 years. Over a median follow-up of almost 5 years, 19 of the 58 patients died. Thirteen of these deaths were due to chronic GVHD with or without infection.

"These results," concluded Dr. Vogelsang, "are encouraging and support the exploration of pentostatin earlier in the course of GVHD, as well as in other immune-mediated disorders, like severe autoimmune diseases and solid organ transplant rejection."

J Clin Oncol 2007;25:4255-4261.