Intra-arterial catheter guided steroid administration for the treatment of steroid-refractory intestinal GvHD

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• 作者：David B眉rgler ; Michael Medinger ; Jakob Passweg ; Arne Fischmann ; Christoph Bucher
• 关键词：Angiography ; Corticosteroids ; Graft-versus-host disease ; Intra-arterial therapy
• 刊名：Leukemia Research
• 出版年：February, 2014
• 年：2014
• 卷：38
• 期：2
• 页码：184-187
• 全文大小：995 K

文摘

Background

Acute gastrointestinal GvHD (GI-aGvHD) refractory to first-line treatment with systemic corticosteroids is resulting in death in the majority of patients. We prospectively assessed the feasibility and efficacy of regional intra-arterial steroid treatment in adult patients with severe (鈮rade III) GI-aGvHD not responding to first-line treatment.

Patients and methods

Patients with more than +++ GI-aGvHD not responding to intravenous methylprednisolone at a dose of 2 mg/kg/day were eligible for inclusion. Catheter guided intra-arterial steroid administration (IASA) was performed into the superior and inferior mesenteric artery.

Results

12 consecutive patients with steroid-refractory grade III GI-aGvHD received IASA as second-line treatment. 83% of patients had gastrointestinal response including four patients (33%) with complete response at 28 days after IASA. 5/12 patients were alive at a median time of 531 days.

Conclusion

Regional treatment of severe GVHD with IASA treatment seems to be a safe and effective second-line treatment for steroid-refractory GI-aGvHD in adult patients.