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Prospective pilot trial of calcipotriene as a novel topical treatment for acute skin graft versus host disease

Bone Marrow Transplantation volume 56, pages 1441–1444 (2021)Cite this article

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Abstract

Skin graft versus host disease (GVHD) can affect quality of life in hematopoietic stem cell transplant recipients. Therapeutic options for steroid-refractory GVHD are limited. We report the first prospective pilot study evaluating the topical vitamin D3 analog Calcipotriene (DOVONEX 0.005% cream) for acute skin GVHD in children, with associated analyses of target organ chemokine CXCL10 changes in response to therapy. We observed that Calcipotriene applications were safe and well tolerated. There were no symptom progression nor new symptoms requiring GVHD therapy escalation during study period. The most consistent response observed by study subjects was resolution of pruritus in eight patients and significant improvement in pruritus in two study subjects. Nine of ten patients had improvement or resolution of skin rash. In addition, we documented reduction of CXCL10 levels in the skin of seven subjects with GVHD after Calcipotriene course using non-invasive D-Squame® disc application to the skin for chemokine analysis. Our pilot study shows promising observation that topical Calcipotriene could be a novel therapeutic option for acute skin GVHD, especially in patients presenting with pruritus and should be studied in larger prospective studies.

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Acknowledgements

The authors wish to thank the patients and their families participating in this study and the Diagnostic Immunology Laboratory (DIL) team for performing study sample testing. Samples used in this study were collected and provided by the staff of the CCHMC BMT tissue repository who we thank for outstanding ongoing technical assistance.

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Authors and Affiliations

  1. Division of Bone Marrow Transplant and Immune Deficiency, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH and Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA

    Gregory Wallace, Pooja Khandelwal, Kasiani C. Myers, Emma M. R. Perentesis, Adam Lane, Kristi Smiley, Stella M. Davies & Sonata Jodele

  2. Department of Pharmacy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Ashley Teusink-Cross

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  1. Gregory Wallace
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  2. Pooja Khandelwal
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  3. Kasiani C. Myers
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  4. Emma M. R. Perentesis
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  5. Adam Lane
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  6. Ashley Teusink-Cross
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  7. Kristi Smiley
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  8. Stella M. Davies
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Correspondence to Gregory Wallace.

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Wallace, G., Khandelwal, P., Myers, K.C. et al. Prospective pilot trial of calcipotriene as a novel topical treatment for acute skin graft versus host disease. Bone Marrow Transplant 56, 1441–1444 (2021). https://doi.org/10.1038/s41409-020-01189-3

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