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.

[madubois63]

Thank you - I love the way everyone is always looking out for everyone else!!!! I put this article in my AML file (hopefully I'll never need it). Although I took huge amounts of steroids (and continue to taper off - I still have my chipmunk cheeks), I experienced steroid refractory GVHD (steroid resistant graft versus host disease). Basically, my liver rejected my donor and stopped filtering the T-cells (?). I turned an awful color green and my eyes glowed yellow. I have one picture where you can see the green on the side of my face. I am leaning now how truly kind and careful everyone was being - playing the situation down. My doctor told me if the treatment did not work, I only had less than a 30% chance of making a year. I think he was being overly kind too. So, in addition to the steroids, I took ATG horse serum treatments. This was deemed my best shot at recovery, and THANK GOD it worked. It took some time for the stuff to kick in. I left the hospital looking like Frankenstein's wife. For me, there wasn't an option of liver transplant - because of my blood not being the donors or mine and not being able to match, being too weak physically and my immune system being so compromised, and no doctor (again) wanting to operate on me (I was actually on the gurney once being wheeled in to surgery to remove my ovaries when the anesthesiologist canceled the surgery because of the fluid in my lungs even though I had clearance - not once, but twice). Geez, I forget all the problems I have encountered along the way, and I am sorry to repeat, but it's easier for me to write it all than for you guys to go search my history (and I can't even remember my stuff - I certainly don't expect you guys too).

BC survivors are AMAZING the docs and living longer (yeah). Unfortunately we are also facing new and unexpected (and crappy) roadblocks to health. AML seems to be gaining strength and over stepping it's boundaries in to the BC world (get out!!). I know others have done it before me, but haven't done as well as I have. I am here for anyone that may need me as you guys have been there for me. Please ask....