The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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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)
  • Received : 2013.07.01
  • Accepted : 2013.10.04
  • Published : 2014.09.01
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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.

Keywords

References

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