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Lactoferrin for gut GVHD

Bone Marrow Transplantation volume 28, pages 1091–1092 (2001)Cite this article

Symptoms of gut graft-versus-host disease (GVHD) are frequent watery diarrhea accompanied by intolerable pain, bloody stool, and paralytic ileus, and these symptoms have serious detrimental effects on both the physical and mental health of patients. It is very difficult to treat severe gut GVHD and we previously reported our experience using colostrum1 in treating this condition. However, the availability of colostrum may be limited and the quality varies. Lactoferrin is an attractive alternative that is abundant in colostrum, and we used recombinant human lactoferrin (Agennix, Houston, TX, USA) for the treatment of gut GVHD refractory to conventional immunosuppressive therapy. Here, we report the dosage and a typical case study.

Lactoferrin was administered orally three times a day for 5 days or more and the dose was set according to the patient's body weight (300 mg/day: −20 kg, 600 mg/day: 20–40 kg, 750 mg/day: +40 kg). No adverse reactions were noted and four out of seven patients with severe gut GVHD showed clinical improvement after lactoferrin administration (Table 1). Rectal biopsies were performed and histological findings were compatible with enteric GVHD in all patients. CMV genome was negative by FISH. Rotaviruses and adenoviruses were not detected in the stool tested by ELISA. One typical case (UPN 204) is reported.

Table 1 Summary of seven cases undergoing lactoferrin therapy for gut GVHD
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References

  1. Inoue M, Okamura T, Sawada A et al. Colostrum and severe gut GVHD Bone Marrow Transplant 1998 22: 402–403

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  2. Levay PF, Viljoen M . Lactoferrin: a general review Hematologica 1995 80: 252–267

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  1. Department of Pediatrics, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, 594-1101, Japan

    M Inoue, T Okamura, M Yasui, N Sakata, K Yagi & K Kawa

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  1. M Inoue
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  2. T Okamura
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  3. M Yasui
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  4. N Sakata
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  5. K Yagi
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Inoue, M., Okamura, T., Yasui, M. et al. Lactoferrin for gut GVHD. Bone Marrow Transplant 28, 1091–1092 (2001). https://doi.org/10.1038/sj.bmt.1703283

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