Clinical Analysis of Salvage Treatment of Glucocorticoid Resistant Graft-Versus-Host Disease with Vedolizumab in Children.
10.19746/j.cnki.issn.1009-2137.2022.06.038
- Author:
Zuo-Feng LI
1
;
Hao XIONG
2
;
Fang TAO
3
;
Zhi CHEN
3
;
Zhuo WANG
3
;
Li YANG
4
;
Ming SUN
4
;
Wen-Jie LU
4
;
Wei TANG
3
;
Lin-Lin LUO
5
;
Su-Jie TANG
5
Author Information
1. Medical College of Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China.
2. Department of Hematology and Oncology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, Hubei Province, China,E-mail: 22587481@qq.com.
3. Department of Hematology and Oncology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, Hubei Province, China.
4. Laboratory of Children's Blood Diseases, Wuhan Children's Hospital, Wuhan 430016, Hubei Province, China.
5. Medical College of Jianghan University, Wuhan 430056, Hubei Province, China.
- Publication Type:Journal Article
- Keywords:
allogeneic hematopoietic stem cell transplantation;
children;
gastrointestinal graft-versus-host disease;
vedolizumab
- MeSH:
Child;
Humans;
Female;
Male;
Child, Preschool;
Salvage Therapy;
Glucocorticoids/therapeutic use*;
Retrospective Studies;
Graft vs Host Disease
- From:
Journal of Experimental Hematology
2022;30(6):1868-1872
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the efficacy and safety of VDZ (Vedolizumab) in the salvage treatment of glucocorticoid resistance to gastrointestinal graft-versus-host disease (GR-GI GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children.
METHODS:The clinical data of 5 patients with refractory GI GVHD who received allo-HSCT in Wuhan Children's Hospital from December 2020 to December 2021 were retrospectively analyzed with VDZ salvage therapy.
RESULTS:Among the 5 children with refractory GI GVHD, there were 1 male and 4 female, including 2 cases of extremely severe aplastic anemia, 1 case of acute myeloid leukemia (M2, high-risk), 1 case of fanconi anemia and 1 case of myelodysplastic syndrome. The median age of transplant recipients was 54.4 (12-164) months. The median treatment time from transplantation to VDZ was 1.4 (0.6-6.8) months. On average, 3.5 (2-5) doses of VDZ were received. After receiving treatment, 2 patients achieved a complete response (CR), 2 patients achieved a very good partial response (VGPR), 1 patient was non-responsive (NR) after a short-term partial response (PR). Compared with that before VDZ treatment, the amount of diarrhea, stool color, blood and traits of the children after medication were effectively improved. The median follow-up time was 9.3 (7.23-12.83) months. No disseminated or severe bacterial/fungal infections occurred during VDZ treatment and follow-up, and 2 children died of leukemia recurrence and pulmonary bronchiolitis obliterans.
CONCLUSION:VDZ salvage treatment of refractory GI GVHD in children has obvious short-term efficacy and good safety.
