Etanercept for steroid-refractory acute graft versus host disease following allogeneic hematopoietic stem cell transplantation.
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.
['Park|Joo Han|JH|', 'Lee|Hyo Jung|HJ|', 'Kim|Sei Rhan|SR|', 'Song|Ga Won|GW|', 'Lee|Seung Kyong|SK|', 'Park|Sun Young|SY|', 'Kim|Ki Chan|KC|', 'Hwang|Sun Hyuk|SH|', 'Park|Joon Seong|JS|']
D000208:Acute Disease D000328:Adult D000368:Aged D064591:Allografts D000068800:Etanercept D005260:Female D006086:Graft vs Host Disease D018380:Hematopoietic Stem Cell Transplantation D006801:Humans D007074:Immunoglobulin G D007166:Immunosuppressive Agents D008297:Male D008875:Middle Aged D018124:Receptors, Tumor Necrosis Factor D012189:Retrospective Studies D013256:Steroids D055815:Young Adult
Stem cell transplantation Graft vs host disease TNFR-Fc fusion protein