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KMID : 0338420140290050630
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The Korean Journal of Internal Medicine
2014 Volume.29 No. 5 p.630 ~ p.636
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Etanercept for steroid-refractory acute graft versus host disease following allogeneic hematopoietic stem cell transplantation
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Park Joo-Han
Lee Hyo-Jung
Kim Sei-Rhan
Song Ga-Won
Lee Seung-Kyong
Park Sun-Young
Kim Ki-Chan
Hwang Sun-Hyuk
Park Joon-Seong
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Abstract
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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.
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KEYWORD
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Stem cell transplantation, Graft vs host disease, TNFR-Fc fusion protein
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