Effect of Etanercept on Steroid Refractory Graft-versus-host Disease in Children
Korean Journal of Hematology
;
: 212-219, 2009.
Artigo
em Coreano
| WPRIM
| ID: wpr-720082
ABSTRACT
BACKGROUND:
Etanercept is a recombinant human soluble tumor necrosis factor-alpha (TNF-alpha) receptor fusion protein that inhibits TNF-alpha, a major mediator in the pathogenesis of graft-versus-host disease (GVHD). The purpose of our study was to evaluate the safety and efficacy of etanercept therapy in children with steroid-refractory acute GVHD (aGVHD) (n=5) and chronic GVHD (cGVHD) (n=3).METHODS:
Five males and 3 females were enrolled and their median age was 14.4 years (range, 2.1~18.8). Etanercept 0.4 mg/kg per dose (maximum dose, 25 mg) was given subcutaneously twice weekly for 4 weeks followed by 0.4 mg/kg per dose (maximum dose, 25 mg) weekly for 4 weeks. At the time of initiation of etanercept, 5 patients had aGVHD grade III to IV (III=4, IV=1) and 3 patients had moderate to severe cGVHD (moderate=1, severe=2).RESULTS:
Overall, 6 of 8 patients (75%) responded to the treatment with etanercept, including 5 patients with aGVHD [n=3 complete response (CR), n=2 partial response (PR)] and 1 patient with cGVHD [n=1 PR, n=2 no response (NR)]. Clinical responses were most commonly seen in patients with refractory gut aGVHD. CMV reactivation occurred in 2 patients, bacterial infection in 1 patient, and fungal infection in 1 patient.CONCLUSION:
Our preliminary data indicate that etanercept is well tolerated and can induce a high response rate in patients with steroid refractory aGVHD, particularly in the setting of intestinal involvement.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Infecções Bacterianas
/
Imunoglobulina G
/
Fator de Necrose Tumoral alfa
/
Receptores do Fator de Necrose Tumoral
/
Transplante de Células-Tronco Hematopoéticas
/
Etanercepte
/
Doença Enxerto-Hospedeiro
Limite:
Criança
/
Feminino
/
Humanos
/
Masculino
Idioma:
Coreano
Revista:
Korean Journal of Hematology
Ano de publicação:
2009
Tipo de documento:
Artigo
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