C. Peters et al., PROPOSAL FOR STANDARD RECOMMENDATIONS FOR PROPHYLAXIS OF GRAFT-VERSUS-HOST DISEASE IN CHILDREN, Bone marrow transplantation, 21, 1998, pp. 57-60
Great variations exist in the practices of graft-versus-host disease p
rophylaxis for children undergoing allogeneic stem cell transplantatio
n. It was the aim of the EBMT Working Party on Paediatric Diseases and
the International Study Group of the BFM-Family, subcommittee bone ma
rrow transplantation (IBFM-SG) to define standard recommendation for p
revention of GVHD. Thus a survey was carried out among the local repre
sentatives of the EBMT WP and IBFM-SG members to define standards for
GVHD prophylaxis basing on available literature data, discussion with
colleagues and their own experience, Presently the majority of regimen
for GVHD prophylaxis are centred on CsA and a short course of MTX wit
h addition of some other immunosuppression leg ATG or ALG) in patients
with high risk for severe GVHD, The proposal defined different catego
ry of patients: patients with malignant disease who are either transpl
anted from HLA matched sibling donors or HLA mismatched family donors
(or volunteer unrelated donors) and patients with non malignant diseas
e who might not benefit from graft-versus-leukaemia effect having eith
er an HLA matched sibling donor or an HLA mismatched family donor (or
volunteer unrelated donor), Homogenous GVHD prophylaxis for defined pa
tient groups should provide better information to optimise strategies
in reducing treatment related toxicity and incidence of relapse by inc
reasing GVL effect.