Thalidomide in the treatment of graft-versus-host disease

The success of allogeneic bone marrow transplantation has been restricted by the occurrence of graft-versus-host disease (GVHD). Attempts at prevention and treatment of GVHD have resulted in only a limited improvement and the morbidity and mortality rate remains high. Thalidomide has been known to have immunosuppressive properties for over 20 years, but it has only recently been used in GVHD. Evidence is now accumulating as to its value both in animal models, and in humans where most benefit has been seen in chronic GVHD. We report our experience using thalidomide in GVHD following allogeneic bone marrow transplantation and review the literature.