Summary:
We treated three patients with steroid-refractory acute graft-versus-host disease (aGVHD) with intra-arterial steroid-injection therapy (IAST). Two patients with gut aGVHD received IAST into both superior and inferior mesenteric arteries, while one patient with liver aGVHD received IAST into the proper hepatic artery. The volume of stools and the bilirubin level improved soon after IAST. Angiography of the superior and inferior mesenteric arteries was performed in the two patients with steroid-refractory gut aGVHD, and identical abnormal findings were obtained. IAST might be an earlier option for steroid-refractory aGVHD.
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References
Martin PJ, Schoch G, Fisher L et al. A retrospective analysis of therapy for acute graft-versus-host disease: secondary treatment. Blood 1991; 77: 1821–1828.
Arai S, Margolis J, Zahurak M et al. Poor outcome in steroid-refractory graft-versus-host disease with antithymocyte globulin treatment. Biol Blood Marrow Transplant 2002; 8: 155–160.
Marty FM, Lee SJ, Fahey MM et al. Infliximab use in patients with severe graft-versus-host disease and other emerging risk factors of non-Candida invasive fungal infections in allogeneic hematopoietic stem cell transplant recipients: a cohort study. Blood 2003; 102: 2768–2776.
Przepiorka D, Kernan NA, Papadopoulos EB et al. Daclizumab, a humanized anti-interleukin-2 receptor alpha chain antibody, for treatment of acute graft-versus-host disease. Blood 2000; 95: 83–89.
Sato T, Sakamaki S, Yasuhiro N et al. Intra-mesenteric artery steroid administration relieved severe refractory gastro-intestinal graft-vs.-host disease in an allogeneic bone marrow transplantation patient. Am J Hematol 1997; 56: 277–280.
Shapira MY, Bloom AI, Or R et al. Intra-arterial catheter directed therapy for severe graft-versus-host disease. Br J Haematol 2002; 119: 760–764.
Tsuchiya M, Miura S, Asakura H et al. Angiographic evaluation of vascular changes in ulcerative colitis. Angiology 1980; 31: 147–153.
Hiramatsu K, Asakura H, Baba S . Selective intraarterial steroid injection in ulcerative colitis. Acta Radiol Diagn 1976; 17: 299–304.
Rogler G, Meinel A, Lingauer A et al. Glucocorticoid receptors are down-regulated in inflamed colonic mucosa but not in peripheral blood mononuclear cells from patients with inflammatory bowel disease. Eur J Clin Invest 1999; 29: 330–336.
Schottelius A, Wedel S, Weltrich R et al. Higher expression of glucocorticoid receptor in peripheral mononuclear cells in inflammatory bowel disease. Am J Gastroenterol 2000; 95: 1945–1999.
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Nakai, K., Tajima, K., Tanigawa, N. et al. Intra-arterial steroid-injection therapy for steroid-refractory acute graft-versus-host disease with the evaluation of angiography. Bone Marrow Transplant 33, 1231–1233 (2004). https://doi.org/10.1038/sj.bmt.1704523
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DOI: https://doi.org/10.1038/sj.bmt.1704523
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