The use of oral beclomethasone dipropionate in the treatment of gastrointestinal graft-versus-host disease: The experience of the Fukuoka Blood and Marrow Transplantation (BMT) Group

Shuichiro Takashima, Tetsuya Eto, Motoaki Shiratsuchi, Michihiro Hidaka, Yasuo Mori, Koji Kato, Kenjiro Kamezaki, Seido Oku, Hideho Henzan, Ken Takase, Takamitsu Matsushima, Katsuto Takenaka, Hiromi Iwasaki, Toshihiro Miyamoto, Koichi Akashi, Takanori Teshima

研究成果: ジャーナルへの寄稿記事

4 引用 (Scopus)

抄録

Objective: We examined the therapeutic strategies for treating mild gastrointestinal (GI) graft-versus-host disease (GVHD) using oral beclomethasone dipropionate (BDP) in 15 Japanese patients based on the donor source. The primary objective was to determine the efficacy and toxicity of oral BDP combined with/without low-dose prednisone (PSL). Methods: Oral BDP was administered with 1 mg/kg/d of PSL in patients undergoing bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT; n=11), and the dose of PSL was tapered off after 22 days. Oral BDP alone was administered in patients undergoing cord blood stem cell transplantation (CBSCT; n=4). The primary endpoint was the rate of treatment success on day 49, as measured according to the improvement or complete resolution of GI symptoms without additional treatment. The secondary endpoints included treatment-related toxicity according to the National Cancer Institute Common Toxicity Criteria version 3.0, the rate of treatment discontinuation due to toxicity, the rate of relapse of acute GVHD by day 100 and the incidence of bacterial, fungal or viral infection, including cytomegalovirus (CMV) antigenemia. Results: Treatment success was achieved in seven of the 11 (64%) patients undergoing BMT or PBSCT and in all four patients (100%) undergoing CBSCT. Subsequent adverse events included herpes zoster infection, catheter-associated sepsis and CMV enteritis; all affected patients responded well to treatment. Conclusion: The use of a risk-stratified treatment strategy with oral BDP depending on the stem cell source is effective in patients with mild GI-GVHD.

元の言語英語
ページ(範囲)1315-1320
ページ数6
ジャーナルInternal Medicine
53
発行部数12
DOI
出版物ステータス出版済み - 2014

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Beclomethasone
Graft vs Host Disease
Transplantation
Bone Marrow
Therapeutics
Cytomegalovirus
Cord Blood Stem Cell Transplantation
Peripheral Blood Stem Cell Transplantation
Catheter-Related Infections
Enteritis
National Cancer Institute (U.S.)
Mycoses
Herpes Zoster
Virus Diseases
Prednisone
Bone Marrow Transplantation
Bacterial Infections
Sepsis
Stem Cells
Tissue Donors

All Science Journal Classification (ASJC) codes

  • Internal Medicine

これを引用

The use of oral beclomethasone dipropionate in the treatment of gastrointestinal graft-versus-host disease : The experience of the Fukuoka Blood and Marrow Transplantation (BMT) Group. / Takashima, Shuichiro; Eto, Tetsuya; Shiratsuchi, Motoaki; Hidaka, Michihiro; Mori, Yasuo; Kato, Koji; Kamezaki, Kenjiro; Oku, Seido; Henzan, Hideho; Takase, Ken; Matsushima, Takamitsu; Takenaka, Katsuto; Iwasaki, Hiromi; Miyamoto, Toshihiro; Akashi, Koichi; Teshima, Takanori.

:: Internal Medicine, 巻 53, 番号 12, 2014, p. 1315-1320.

研究成果: ジャーナルへの寄稿記事

Takashima, Shuichiro ; Eto, Tetsuya ; Shiratsuchi, Motoaki ; Hidaka, Michihiro ; Mori, Yasuo ; Kato, Koji ; Kamezaki, Kenjiro ; Oku, Seido ; Henzan, Hideho ; Takase, Ken ; Matsushima, Takamitsu ; Takenaka, Katsuto ; Iwasaki, Hiromi ; Miyamoto, Toshihiro ; Akashi, Koichi ; Teshima, Takanori. / The use of oral beclomethasone dipropionate in the treatment of gastrointestinal graft-versus-host disease : The experience of the Fukuoka Blood and Marrow Transplantation (BMT) Group. :: Internal Medicine. 2014 ; 巻 53, 番号 12. pp. 1315-1320.
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title = "The use of oral beclomethasone dipropionate in the treatment of gastrointestinal graft-versus-host disease: The experience of the Fukuoka Blood and Marrow Transplantation (BMT) Group",
abstract = "Objective: We examined the therapeutic strategies for treating mild gastrointestinal (GI) graft-versus-host disease (GVHD) using oral beclomethasone dipropionate (BDP) in 15 Japanese patients based on the donor source. The primary objective was to determine the efficacy and toxicity of oral BDP combined with/without low-dose prednisone (PSL). Methods: Oral BDP was administered with 1 mg/kg/d of PSL in patients undergoing bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT; n=11), and the dose of PSL was tapered off after 22 days. Oral BDP alone was administered in patients undergoing cord blood stem cell transplantation (CBSCT; n=4). The primary endpoint was the rate of treatment success on day 49, as measured according to the improvement or complete resolution of GI symptoms without additional treatment. The secondary endpoints included treatment-related toxicity according to the National Cancer Institute Common Toxicity Criteria version 3.0, the rate of treatment discontinuation due to toxicity, the rate of relapse of acute GVHD by day 100 and the incidence of bacterial, fungal or viral infection, including cytomegalovirus (CMV) antigenemia. Results: Treatment success was achieved in seven of the 11 (64{\%}) patients undergoing BMT or PBSCT and in all four patients (100{\%}) undergoing CBSCT. Subsequent adverse events included herpes zoster infection, catheter-associated sepsis and CMV enteritis; all affected patients responded well to treatment. Conclusion: The use of a risk-stratified treatment strategy with oral BDP depending on the stem cell source is effective in patients with mild GI-GVHD.",
author = "Shuichiro Takashima and Tetsuya Eto and Motoaki Shiratsuchi and Michihiro Hidaka and Yasuo Mori and Koji Kato and Kenjiro Kamezaki and Seido Oku and Hideho Henzan and Ken Takase and Takamitsu Matsushima and Katsuto Takenaka and Hiromi Iwasaki and Toshihiro Miyamoto and Koichi Akashi and Takanori Teshima",
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doi = "10.2169/internalmedicine.53.1858",
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TY - JOUR

T1 - The use of oral beclomethasone dipropionate in the treatment of gastrointestinal graft-versus-host disease

T2 - The experience of the Fukuoka Blood and Marrow Transplantation (BMT) Group

AU - Takashima, Shuichiro

AU - Eto, Tetsuya

AU - Shiratsuchi, Motoaki

AU - Hidaka, Michihiro

AU - Mori, Yasuo

AU - Kato, Koji

AU - Kamezaki, Kenjiro

AU - Oku, Seido

AU - Henzan, Hideho

AU - Takase, Ken

AU - Matsushima, Takamitsu

AU - Takenaka, Katsuto

AU - Iwasaki, Hiromi

AU - Miyamoto, Toshihiro

AU - Akashi, Koichi

AU - Teshima, Takanori

PY - 2014

Y1 - 2014

N2 - Objective: We examined the therapeutic strategies for treating mild gastrointestinal (GI) graft-versus-host disease (GVHD) using oral beclomethasone dipropionate (BDP) in 15 Japanese patients based on the donor source. The primary objective was to determine the efficacy and toxicity of oral BDP combined with/without low-dose prednisone (PSL). Methods: Oral BDP was administered with 1 mg/kg/d of PSL in patients undergoing bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT; n=11), and the dose of PSL was tapered off after 22 days. Oral BDP alone was administered in patients undergoing cord blood stem cell transplantation (CBSCT; n=4). The primary endpoint was the rate of treatment success on day 49, as measured according to the improvement or complete resolution of GI symptoms without additional treatment. The secondary endpoints included treatment-related toxicity according to the National Cancer Institute Common Toxicity Criteria version 3.0, the rate of treatment discontinuation due to toxicity, the rate of relapse of acute GVHD by day 100 and the incidence of bacterial, fungal or viral infection, including cytomegalovirus (CMV) antigenemia. Results: Treatment success was achieved in seven of the 11 (64%) patients undergoing BMT or PBSCT and in all four patients (100%) undergoing CBSCT. Subsequent adverse events included herpes zoster infection, catheter-associated sepsis and CMV enteritis; all affected patients responded well to treatment. Conclusion: The use of a risk-stratified treatment strategy with oral BDP depending on the stem cell source is effective in patients with mild GI-GVHD.

AB - Objective: We examined the therapeutic strategies for treating mild gastrointestinal (GI) graft-versus-host disease (GVHD) using oral beclomethasone dipropionate (BDP) in 15 Japanese patients based on the donor source. The primary objective was to determine the efficacy and toxicity of oral BDP combined with/without low-dose prednisone (PSL). Methods: Oral BDP was administered with 1 mg/kg/d of PSL in patients undergoing bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT; n=11), and the dose of PSL was tapered off after 22 days. Oral BDP alone was administered in patients undergoing cord blood stem cell transplantation (CBSCT; n=4). The primary endpoint was the rate of treatment success on day 49, as measured according to the improvement or complete resolution of GI symptoms without additional treatment. The secondary endpoints included treatment-related toxicity according to the National Cancer Institute Common Toxicity Criteria version 3.0, the rate of treatment discontinuation due to toxicity, the rate of relapse of acute GVHD by day 100 and the incidence of bacterial, fungal or viral infection, including cytomegalovirus (CMV) antigenemia. Results: Treatment success was achieved in seven of the 11 (64%) patients undergoing BMT or PBSCT and in all four patients (100%) undergoing CBSCT. Subsequent adverse events included herpes zoster infection, catheter-associated sepsis and CMV enteritis; all affected patients responded well to treatment. Conclusion: The use of a risk-stratified treatment strategy with oral BDP depending on the stem cell source is effective in patients with mild GI-GVHD.

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U2 - 10.2169/internalmedicine.53.1858

DO - 10.2169/internalmedicine.53.1858

M3 - Article

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VL - 53

SP - 1315

EP - 1320

JO - Internal Medicine

JF - Internal Medicine

SN - 0918-2918

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