The Korean journal of internal medicine

  • 제29권5호
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  • Pages.630-636
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  • 2014
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Etanercept for steroid-refractory acute graft versus host disease following allogeneic hematopoietic stem cell transplantation

  • Park, Joo Han (Department of Hematology and Oncology, Ajou University School of Medicine) ;
  • Lee, Hyo Jung (Department of Hematology and Oncology, Ajou University School of Medicine) ;
  • Kim, Sei Rhan (Department of Hematology and Oncology, Ajou University School of Medicine) ;
  • Song, Ga Won (Department of Hematology and Oncology, Ajou University School of Medicine) ;
  • Lee, Seung Kyong (Department of Hematology and Oncology, Ajou University School of Medicine) ;
  • Park, Sun Young (Department of Hematology and Oncology, Ajou University School of Medicine) ;
  • Kim, Ki Chan (Department of Hematology and Oncology, Ajou University School of Medicine) ;
  • Hwang, Sun Hyuk (Department of Hematology and Oncology, Ajou University School of Medicine) ;
  • Park, Joon Seong (Department of Hematology and Oncology, Ajou University School of Medicine)
  • 투고 : 2013.07.01
  • 심사 : 2013.10.04
  • 발행 : 2014.09.01
⟨ 이전 논문 다음 논문 ⟩

초록

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.

키워드

참고문헌

  1. MacMillan ML, Weisdorf DJ, Wagner JE, et al. Response of 443 patients to steroids as primary therapy for acute graft-versus-host disease: comparison of grading systems. Biol Blood Marrow Transplant 2002;8:387-394. https://doi.org/10.1053/bbmt.2002.v8.pm12171485
  2. Levine JE, Paczesny S, Mineishi S, et al. Etanercept plus methylprednisolone as initial therapy for acute graft-versus- host disease. Blood 2008;111:2470-2475. https://doi.org/10.1182/blood-2007-09-112987
  3. Kim DH, Sohn SK, Baek JH, et al. Retrospective multicenter study of allogeneic peripheral blood stem cell transplantation followed by reduced-intensity conditioning or conventional myeloablative regimen. Acta Haematol 2005;113:220-227. https://doi.org/10.1159/000084674
  4. Weisdorf D, Haake R, Blazar B, et al. Treatment of moderate/ severe acute graft-versus-host disease after allogeneic bone marrow transplantation: an analysis of clinical risk features and outcome. Blood 1990;75:1024-1030.
  5. Basara N, Blau WI, Romer E, et al. Mycophenolate mofetil for the treatment of acute and chronic GVHD in bone marrow transplant patients. Bone Marrow Transplant 1998;22:61-65. https://doi.org/10.1038/sj.bmt.1701281
  6. Arai S, Margolis J, Zahurak M, Anders V, Vogelsang GB. Poor outcome in steroid-refractory graft-versus-host disease with antithymocyte globulin treatment. Biol Blood Marrow Transplant 2002;8:155-160. https://doi.org/10.1053/bbmt.2002.v8.pm11939605
  7. Markey KA, Burman AC, Banovic T, et al. Soluble lymphotoxin is an important effector molecule in GVHD and GVL. Blood 2010;115:122-132. https://doi.org/10.1182/blood-2009-01-199927
  8. Uberti JP, Ayash L, Ratanatharathorn V, et al. Pilot trial on the use of etanercept and methylprednisolone as primary treatment for acute graft-versus-host disease. Biol Blood Marrow Transplant 2005;11:680-687. https://doi.org/10.1016/j.bbmt.2005.05.009
  9. Filipovich AH, Weisdorf D, Pavletic S, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. diagnosis and staging working group report. Biol Blood Marrow Transplant 2005;11:945-956. https://doi.org/10.1016/j.bbmt.2005.09.004
  10. Przepiorka D, Weisdorf D, Martin P, et al. 1994 Consensus Conference on acute GVHD grading. Bone Marrow Transplant 1995;15:825-828.
  11. Bacigalupo A. Management of acute graft-versus-host disease. Br J Haematol 2007;137:87-98. https://doi.org/10.1111/j.1365-2141.2007.06533.x
  12. Wolff D, Roessler V, Steiner B, et al. Treatment of steroid- resistant acute graft-versus-host disease with daclizumab and etanercept. Bone Marrow Transplant 2005;35:1003-1010. https://doi.org/10.1038/sj.bmt.1704929
  13. Maeda Y, Levy RB, Reddy P, et al. Both perforin and Fas ligand are required for the regulation of alloreactive CD8+ T cells during acute graft-versus-host disease. Blood 2005;105:2023-2027. https://doi.org/10.1182/blood-2004-08-3036
  14. Herve P, Flesch M, Tiberghien P, et al. Phase I-II trial of a monoclonal anti-tumor necrosis factor alpha antibody for the treatment of refractory severe acute graft-versushost disease. Blood 1992;79:3362-3368.
  15. Hattori K, Hirano T, Miyajima H, et al. Differential effects of anti-Fas ligand and anti-tumor necrosis factor alpha antibodies on acute graft-versus-host disease pathologies. Blood 1998;91:4051-4055.
  16. Mollee P, Morton AJ, Irving I, Durrant S. Combination therapy with tacrolimus and anti-thymocyte globulin for the treatment of steroid-resistant acute graft-versus-host disease developing during cyclosporine prophylaxis. Br J Haematol 2001;113:217-223. https://doi.org/10.1046/j.1365-2141.2001.02741.x
  17. Kennedy GA, Butler J, Western R, Morton J, Durrant S, Hill GR. Combination antithymocyte globulin and soluble TNFalpha inhibitor (etanercept) +/- mycophenolate mofetil for treatment of steroid refractory acute graft-versus- host disease. Bone Marrow Transplant 2006;37:1143-1147. https://doi.org/10.1038/sj.bmt.1705380

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  8. Targeting Regulatory T Cells by Addressing Tumor Necrosis Factor and Its Receptors in Allogeneic Hematopoietic Cell Transplantation and Cancer vol.10, pp.None, 2014, https://doi.org/10.3389/fimmu.2019.02040
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  11. Worldwide Network for Blood and Marrow Transplantation (WBMT) perspective: the role of biosimilars in hematopoietic cell transplant: current opportunities and challenges in low- and lower-middle incom vol.55, pp.4, 2014, https://doi.org/10.1038/s41409-019-0658-2
  12. Ruxolitinib combined with etanercept induce a rapid response to corticosteroid‐refractory severe acute graft vs host disease after allogeneic stem cell transplantation: Results of a multi‐ vol.95, pp.9, 2014, https://doi.org/10.1002/ajh.25898
  13. Production, safety and efficacy of iPSC-derived mesenchymal stromal cells in acute steroid-resistant graft versus host disease: a phase I, multicenter, open-label, dose-escalation study vol.26, pp.11, 2014, https://doi.org/10.1038/s41591-020-1050-x
  14. Mesenchymal Stromal Cells for the Treatment of Graft Versus Host Disease vol.12, pp.None, 2014, https://doi.org/10.3389/fimmu.2021.761616
  15. Immunomodulatory Therapies for the Treatment of Graft-versus-host Disease vol.5, pp.6, 2014, https://doi.org/10.1097/hs9.0000000000000581