Cyclosporine A for the Prevention of Ocular Graft versus Host Disease in Allogeneic Hematopoietic Stem Cell Transplant Recipients Is Safe and Feasible


Por: Cantú-Rodríguez O.G., Vázquez-Mellado A., González-Treviño J.L., Martínez-Garza D.M., Gómez-De León A., Hawing-Zarate J.A., Jaime-Pérez J.C., Gutierrez-Aguirre C.H., Garza-Acosta A.C., Mancías-Guerra C., González-Llano O., González-Cantú G.A., Herrera-Rojas M.A., Sada-Ovalle I., Gómez-Almaguer D.
Ahead of Print: 1 ene 2019
Resumen:
Purpose: To evaluate the safety and efficacy of ocular cyclosporine in the prevention of the development of ocular graft versus host disease (oGVHD) in patients undergoing allogeneic hematopoietic stem cell transplantation (AHSCT) in comparison with historic data. Design: We developed a longitudinal, observational, prospective nonrandomized study. We evaluated the feasibility of prophylactic use of topical cyclosporine A (CsA) to prevent or decrease the incidence of oGVHD and compared this with historic data. Methods: Patients undergoing AHSCT were treated with prophylactic topical CsA for 12 months after engraftment, followed by serial ophthalmic evaluations, including the Schirmer test. Results: Twenty patients were included. No serious adverse effects were reported. Poor adherence was documented in 15% of patients. In spite of observing extra-ocular GVHD (acute and chronic GVHD incidence of 50 and 45%, respectively), only 1 in 20 patients developed oGVHD over the 20-month follow-up for the entire cohort. No statistically significant difference was observed in the incidence of oGVHD when compared to a historical cohort. Conclusions: Topical CsA as a prophylactic measure for oGVHD, administered over a period of 1 year after grafting, is safe and feasible and may decrease the incidence of ophthalmic manifestations of GVHD. These findings must be confirmed in a randomized trial. © 2019 S. Karger AG, Basel. All rights reserved.
Filiaciones:
Cantú-Rodríguez O.G.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
Vázquez-Mellado A.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
González-Treviño J.L.:
 Régimen Estatal de Protección Social en Salud, Monterrey, Mexico
Martínez-Garza D.M.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
Gómez-De León A.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
Hawing-Zarate J.A.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
Jaime-Pérez J.C.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
Gutierrez-Aguirre C.H.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
Garza-Acosta A.C.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
Mancías-Guerra C.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
González-Llano O.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
González-Cantú G.A.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
Herrera-Rojas M.A.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
Sada-Ovalle I.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
Gómez-Almaguer D.:
 Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González Hematology Service, Madero y Gonzalitos S/N, Colonia Mitras Centro, Monterrey, 64460, Mexico
ISSN: 00015792
Editorial
S. Karger AG, Suiza
Tipo de documento: Article
Volumen: Número:
Páginas:
WOS Id: 000574017000006
ID de PubMed: 31505491