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Gut protection by palifermin during autologous haematopoietic SCT.

Artikel i vetenskaplig tidskrift
Författare J-E Johansson
Bengt Hasséus
P Johansson
C Eklöf
D Ohman
Dick Stockelberg
Publicerad i Bone marrow transplantation
Volym 43
Nummer/häfte 10
Sidor 807-11
ISSN 1476-5365
Publiceringsår 2009
Publicerad vid Institutionen för odontologi
Sidor 807-11
Språk en
Länkar dx.doi.org/10.1038/bmt.2008.388
Ämnesord Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, therapeutic use, Female, Fibroblast Growth Factor 7, administration & dosage, pharmacology, Hematopoietic Stem Cell Transplantation, methods, Humans, Intestinal Mucosa, drug effects, Male, Middle Aged, Parenteral Nutrition, Permeability, drug effects, Protective Agents, Transplantation Conditioning, methods, Transplantation, Autologous, Young Adult
Ämneskategorier Dermatologi och venereologi, Övrig odontologi

Sammanfattning

Conditioning therapy in connection with haematopoietic SCT (HSCT) induces a disruption of the intestinal barrier function facilitating the permeation of bacteria and endotoxin through the bowel wall with subsequent increased risk of septicaemia and a worsening of GVHD in the allogeneic setting. Palifermin (recombinant human keratinocyte growth factor) reduces the severity of oral mucositis with HSCT. The present trial investigates its effect on intestinal barrier function. Seventeen lymphoma patients undergoing autologous HSCT received palifermin. Intestinal permeability was assessed before the conditioning therapy and on days +4 and +14. Clinical oral and gastrointestinal toxicity was prospectively assessed in parallel. A comparison was made with matched historical study patients (n=21). Patients treated with palifermin had a significantly better preserved intestinal barrier function (P=0.01 on day +4) and were in less need of total parenteral nutrition (P=0.005) as compared with controls. No significant reduction of clinical gastrointestinal or oral toxicity was observed. The intestinal barrier function, normally disrupted by the conditioning therapy, is preserved by palifermin. Whether intestinal barrier preservation protects from invasive infections, and in the allogeneic setting diminishes GVHD severity, remains to be investigated in randomized controlled trials.

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