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How we can mitigate the side effects associated with systemic glucocorticoid after allogeneic hematopoietic cell transplantation

Bone Marrow Transplantation volume 56, pages 1248–1256 (2021)Cite this article

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Abstract

Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative treatment for patients with a hematologic disease. Although the clinical outcomes after allo-HCT have significantly improved during the last few decades, graft-versus-host disease (GVHD) is still a major cause of post-HCT morbidity and mortality. Systemic glucocorticoids (GC) remain an integral part of treatment in patients with GVHD including both acute and chronic GVHD. Although it is well-known that usage of systemic GC is associated with various side effects, the short- and long-term effects of GCs in the HCT setting are not well-characterized due to limited published data. In order to clarify this issue, we summarize the information on side effects associated with GCs, focusing specifically on the sequelae of these agents in the early post-HCT period. In instances where limited data are available, we included data from other fields such as autoimmune diseases, given the potential parallels between autoimmune conditions and GVHD.

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Acknowledgements

This study was partly supported by Health, Labour and Welfare Sciences Research Grants (20FF1002).

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Authors and Affiliations

  1. Department of Hematology, Osaka International Cancer Institute, Osaka, Japan

    Shigeo Fuji

  2. Hematology and Stem Cell Transplantation Section, Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center and Veterans Affairs Medical Center, Nashville, TN, USA

    Michael Byrne & Bipin N. Savani

  3. Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel

    Arnon Nagler

  4. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Arnon Nagler

  5. Service d’Hématologie Clinique, Hopital Saint-Antoine, Sorbonne University, INSERM UMRs 938, Paris, France

    Mohamad Mohty

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Fuji, S., Byrne, M., Nagler, A. et al. How we can mitigate the side effects associated with systemic glucocorticoid after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 56, 1248–1256 (2021). https://doi.org/10.1038/s41409-020-01205-6

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