Palifermin does not influence the incidence and severity of GvHD nor long-term survival of patients with hematological diseases undergoing HSCT
Barbara Nasilowska-Adamska, Richard Szydlo, Piotr Rzepecki, Anna Czyz, Agnieszka Tomaszewska, Miroslaw Markiewicz, Tigran Torosian, Maria Bieniaszewska, Andrzej Hellman, Wieslaw Wiktor Jedrzejczak, Jerzy Holowiecki, Mieczyslaw Komarnicki, Krzysztof Warzocha, Bozena Marianska
Ann Transplant 2011; 16(4): 47-54
Background: Palifermin is known as the effective growth factor to reduce the incidence, duration and severity of oral mucositis (OM) following hematopoietic stem cell transplantation (HSCT). However, additional data on the long-term safety of palifermin and its potential influence on graft versus host disease (GvHD) are needed.
Material/Methods: In this multi-center, non-randomized, matched-control study we assessed early overall survival (OS), incidence and severity of acute/chronic GvHD (a/cGvHD) and incidence of secondary malignancies in 36 patients with hematological diseases treated with allogeneic HSCT and palifermin.
Results: The incidence of aGvHD was 28.2% and 38.4% (p=0.34) and cGvHD 41% and 53.8% (p=0.70) in the palifermin and control groups, respectively. The incidence of aGvHD grade 0–IV was 69.2%, 5.1%, 17.9%, 2.5%, 2.5% in the palifermin group and 61.5%, 12.8%, 12.8%, 10.2%, 5.2% in the control group, respectively (p>0.4 for each). The incidence of limited and extensive cGvHD was 17.9% and 23% in the palifermin versus 25.6% and 28.2% in the control group (p=0.32 and p=0.50, respectively).
The estimated 3-year OS did not differ significantly between studied groups. We did not observe any secondary malignancies in these patients.
Conclusions: Administration of palifermin doesn’t seem to influence the incidence and severity of aGvHD/cGvHD, secondary malignancies occurrence and early OS in patients undergoing allogeneic HSCT.
Keywords: Secondary malignancy, GvHD, palifermin, allogeneic HSCT