Corey Cutler1, Joseph H Antin. 1. Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA. corey_cutler@dfci.harvard.edu
Abstract
PURPOSE OF REVIEW: Sirolimus is being used increasingly as an immunosuppressant in allogeneic hematopoietic stem cell transplantation. This article reviews recent results in sirolimus-based graft-versus-host disease (GVHD) prophylaxis, as well as outcomes using sirolimus for established acute and chronic GVHD. RECENT FINDINGS: In uncontrolled experiments, sirolimus provides good control of steroid-resistant acute or chronic GVHD. Similarly, the addition of sirolimus to GVHD prophylaxis regimens appears to reduce the rate of acute GVHD in the myeloablative and reduced-intensity settings, when used in matched, related, and unrelated donor transplantation. The use of sirolimus in haploidentical transplantation is now being explored as well. SUMMARY: Sirolimus should be considered for use in steroid-resistant acute and chronic GVHD. Sirolimus appears promising as primary prophylaxis for GVHD prevention. Randomized trials are currently being performed to determine whether sirolimus-based immunosuppression is superior to traditional GVHD prophylaxis.
PURPOSE OF REVIEW: Sirolimus is being used increasingly as an immunosuppressant in allogeneic hematopoietic stem cell transplantation. This article reviews recent results in sirolimus-based graft-versus-host disease (GVHD) prophylaxis, as well as outcomes using sirolimus for established acute and chronic GVHD. RECENT FINDINGS: In uncontrolled experiments, sirolimus provides good control of steroid-resistant acute or chronic GVHD. Similarly, the addition of sirolimus to GVHD prophylaxis regimens appears to reduce the rate of acute GVHD in the myeloablative and reduced-intensity settings, when used in matched, related, and unrelated donor transplantation. The use of sirolimus in haploidentical transplantation is now being explored as well. SUMMARY:Sirolimus should be considered for use in steroid-resistant acute and chronic GVHD. Sirolimus appears promising as primary prophylaxis for GVHD prevention. Randomized trials are currently being performed to determine whether sirolimus-based immunosuppression is superior to traditional GVHD prophylaxis.
Authors: R Parody; L Lopez-Corral; O L Godino; I G Cadenas; A P Martinez; L Vazquez; R Martino; C Martinez; C Solano; P Barba; D Valcarcel; T Caballero-Velazquez; F J Marquez-Malaver; J Sierra; D Caballero; J A Perez-Simón Journal: Bone Marrow Transplant Date: 2014-10-13 Impact factor: 5.483
Authors: Caron A Jacobson; Lixian Sun; Haesook T Kim; Sean M McDonough; Carol G Reynolds; Michael Schowalter; John Koreth; Corey S Cutler; Vincent T Ho; Edwin P Alyea; Philippe Armand; Bruce R Blazar; Robert J Soiffer; Joseph H Antin; Jerome Ritz; Stefanie Sarantopoulos Journal: Biol Blood Marrow Transplant Date: 2014-01-23 Impact factor: 5.742
Authors: John Koreth; Kristen E Stevenson; Haesook T Kim; Sean M McDonough; Bhavjot Bindra; Philippe Armand; Vincent T Ho; Corey Cutler; Bruce R Blazar; Joseph H Antin; Robert J Soiffer; Jerome Ritz; Edwin P Alyea Journal: J Clin Oncol Date: 2012-08-06 Impact factor: 44.544