Etanercept for steroid-refractory acute graft versus host disease following allogeneic hematopoietic stem cell transplantation.
10.3904/kjim.2014.29.5.630
- Author:
Joo Han PARK
1
;
Hyo Jung LEE
;
Sei Rhan KIM
;
Ga Won SONG
;
Seung Kyong LEE
;
Sun Young PARK
;
Ki Chan KIM
;
Sun Hyuk HWANG
;
Joon Seong PARK
Author Information
1. Department of Hematology and Oncology, Ajou University School of Medicine, Suwon, Korea. jspark65@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
Stem cell transplantation;
Graft vs host disease;
TNFR-Fc fusion protein
- MeSH:
Acute Disease;
Adult;
Aged;
Allografts;
Female;
Graft vs Host Disease/etiology/*therapy;
Hematopoietic Stem Cell Transplantation/*adverse effects;
Humans;
Immunoglobulin G/adverse effects/*therapeutic use;
Immunosuppressive Agents/adverse effects/therapeutic use;
Male;
Middle Aged;
Receptors, Tumor Necrosis Factor/*therapeutic use;
Retrospective Studies;
Steroids/therapeutic use;
Young Adult
- From:The Korean Journal of Internal Medicine
2014;29(5):630-636
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The treatment for steroid-refractory acute graft versus host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT) needs to be standardized. We report our clinical experience with etanercept for steroid-refractory acute GVHD. METHODS: Eighteen patients who underwent allo-SCT and presented with steroid-refractory acute GVHD at Ajou University Hospital were studied retrospectively. They were given 25 mg of etanercept subcutaneously twice weekly for 4 weeks. The clinical responses were evaluated with regard to the severity of acute GVHD. RESULTS: The median patient age was 43.5 years. Using nonparametric tests, etanercept had a down-grading effect on acute GVHD (p = 0.005), although no patient experienced complete remission. Partial responses were seen in 80%, 17%, and 57% of grade II to IV patients, respectively. Skin and gut GVHD were well controlled with etanercept, whereas hepatic GVHD was not. Four patients died of fatal infections. No factors affecting the clinical outcome of etanercept were identified. CONCLUSIONS: Etanercept has a modest effect on steroid-refractory acute GVHD after allo-SCT, with tolerable side effects.
