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Abstract
Acute graft-versus-host disease (GVHD) is one of the most severe complications following allogeneic stem cell transplantation (SCT), and involvement of the gut has been associated with increased mortality and a poorer response to high-dose systemic corticosteroids. For over a decade, oral beclomethasone dipropionate (BDP) has been studied in the treatment of acute gastrointestinal GVHD, as a monotherapy, or in combination with systemic corticosteroids. Here we report, for the first time in Korea, the efficacy of oral BDP (8 mg/day for 25 days) in 3 adults with acute lymphoblastic leukemia who developed steroid-refractory gastrointestinal GVHD (grade III) after myeloablative conditioning SCT (1 matched sibling transplant, 2 matched unrelated transplants). All patients responded completely to oral BDP treatment. Oral BDP is safe and effective for the control of steroid-refractory acute gastrointestinal GVHD.
References
1. Weissinger EM, Schiffer E, Hertenstein B, et al. Proteomic patterns predict acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. Blood. 2007; 109:5511–9.
2. Deeg HJ. How I treat refractory acute GVHD. Blood. 2007; 109:4119–26.
3. Baehr PH, Levine DS, Bouvier ME, et al. Oral beclomethasone dipropionate for treatment of human intestinal graft-versus-host disease. Transplantation. 1995; 60:1231–8.
4. McDonald GB, Bouvier M, Hockenbery DM, et al. Oral beclomethasone dipropionate for treatment of intestinal graft-versus-host disease: a randomized controlled trial. Gastroenterology. 1998; 115:28–35.
5. Hockenbery DM, Cruickshank S, Rodell TC, et al. A randomized, placebocontrolled trial of oral beclomethasone dipropionate as a prednisone-sparing therapy for gastrointestinal graft-versus-host disease. Blood. 2007; 109:4557–63.
6. Messina C, Faraci M, de Fazio V, Dini G, CalòMP , Calore E. EBMT Paediatric Working Party. Prevention and treatment of acute GvHD. Bone Marrow Transplant. 2008; 41(Suppl 2):S65–70.
7. Castilla C, Pérez-Simón JA, Sanchez-Guijo FM, et al. Oral beclomethasone dipropionate for the treatment of gastrointestinal acute graft-versus-host disease (GVHD). Biol Blood Marrow Transplant. 2006; 12:936–41.
8. Ibrahim RB, Abidi MH, Cronin SM, et al. Nonabsorbable corticosteroids use in the treatment of gastrointestinal graft-versus-host disease. Biol Blood Marrow Transplant. 2009; 15:395–405.
9. Iyer RV, Hahn T, Roy HN, et al. Long-term use of oral beclomethasone dipropionate for the treatment of gastrointestinal graft-versushost disease. Biol Blood Marrow Transplant. 2005; 11:587–92.
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