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Graft-Versus-Host Disease

Fecal calprotectin and α1-antitrypsin dynamics in gastrointestinal GvHD

Bone Marrow Transplantation volume 50, pages 1105–1109 (2015)Cite this article

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Abstract

In a previous study, the fecal biomarkers calprotectin and α1-antitrypsin (α1-AT) at symptom onset were reported to be significantly associated with the response to steroids in gastrointestinal GvHD (GI-GvHD). The purpose of this trial was to evaluate the dynamics of the fecal biomarkers calprotectin and α1-AT throughout the course of GvHD. Patients who were refractory to steroids had initially higher biomarker levels and in the course of GvHD demonstrated a continuous increase in fecal biomarkers. In contrast, the dynamics of calprotectin and α1-AT demonstrated low and decreasing levels in cortico-sensitive GvHD. In steroid-refractory patients who received a second line of treatment, the biomarker levels at the beginning of second-line treatment did not predict the subsequent response. Nevertheless, calprotectin levels progressively decreased in subsequent responders, whereas non-responders demonstrated continuously high levels of calprotectin. α1-AT values correlated to a lesser extent with the response to second-line treatment and remained elevated in both non-responders and responders. In conclusion, calprotectin monitoring can be of use in the management of immunosuppressive treatment in GI-GvHD.

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Acknowledgements

The project was support by the association ‘sang pour cent la vie’, Laurette Fugain and received a grant from INCA/DGOS TRANSLA 13–122. AO received funding from the Margarete and Walter Lichtenstein foundation. Trial registration: 2009/30 NI study and 2014/43NICB.

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Authors and Affiliations

  1. Service de Greffe de Moelle, Hôpital Saint-Louis, AP-HP, Université Paris Diderot, Paris, France

    A O'Meara, A Xhaard, F Sicre de Fontbrune, G Socié & M Robin

  2. Service de Coprologie Fonctionnelle, Hôpitaux Universitaire Pitié Salpêtrière – Charles Foix, AP-HP, Paris, France

    N Kapel & D Manéné

  3. Service Greffe de Moelle, Unité Adolescents et Jeunes Adultes, Hôpital Saint-Louis, AP-HP, Paris, France

    N Dhedin

  4. Inserm U728, Paris, France

    R P de Latour & G Socié

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  1. A O'Meara
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  2. N Kapel
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  9. M Robin
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Correspondence to M Robin.

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O'Meara, A., Kapel, N., Xhaard, A. et al. Fecal calprotectin and α1-antitrypsin dynamics in gastrointestinal GvHD. Bone Marrow Transplant 50, 1105–1109 (2015). https://doi.org/10.1038/bmt.2015.109

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  • DOI: https://doi.org/10.1038/bmt.2015.109

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