Palifermin use in children and adolescents undergoing allogeneic hematopoietic stem cell transplantation
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 9
Abstract
Introducton. Palifermin, a recombinant human keratinocyte growth factor, is used in adults to prevent oral mucositis following allogeneic stem cell transplantation. Palifermin decreases total parenteral nutrition, length of initial hospital stay and opioid usage in pain control caused by oral mucositis in adults.Aim. The objective of this prospective study was the analysis of safety and efficacy of palifermin in children and adolescents.Material and methods. Seventy-nine consecutive patients undergoing allogeneic stem cell transplantation and treated with palifermin were included into the study. The results of efficacy were compared to data of 32 patients, not treated with palifemin.Results. Palifermin decreased incidence of severe oral mucositis (grade 3 and 4 WHO), acute graft versus host disease (≥ 2 grade), chronic graft versus host disease, and opioid usage in pain control caused by oral mucositis. Palifermin did not affect time of total parenteral nutrition. Adverse events of palifermin use were observed only in one patient as generalized itch and erythema. Data obtained in particular subgroups: type of donor (sibling vs alternative) or type of conditioning (chemotherapy vs TBI-based) reached different statistical significance level, what was limited by number of patients in particular subgroups.Conclusions. Palifermin is a safe drug when used in children and adolescents undergoing allogeneic stem cell transplantation. The use of this drug leads to significant decrease of mucosal toxicity and frequency of acute and chronic GVHD.
Authors and Affiliations
Krzysztof Czyżewski, Jan Styczyński, Robert Dębski, Anna Kręska, Mariusz Wysocki
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