Vedolizumab for pediatric patients with gastrointestinal acute graft-versus-host-disease.
gastrointestinal GVHD
pediatric stem cell transplantation
vedolizumab
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
revised:
06
09
2022
received:
11
07
2022
accepted:
26
09
2022
pubmed:
4
11
2022
medline:
30
11
2022
entrez:
3
11
2022
Statut:
ppublish
Résumé
Vedolizumab, an anti-α4β7 integrin monoclonal antibody, impairs homing of T-cells to the gastrointestinal (GI) endothelium and acts as a gut-selective anti-inflammatory agent. Recent reports of the efficacy of vedolizumab in treating lower GI acute graft-versus-host disease (aGVHD) are promising, but experience in children is scarce. We present a cohort of 13 pediatric patients who were treated with vedolizumab for GI aGVHD. Ten of the patients were treated for steroid-refractory disease, out of which, six suffered from severe (stage 3 or 4) GI disease before the first dose of vedolizumab. In the other three patients, vedolizumab was introduced early in the disease course. Median time between GI GVHD onset to vedolizumab treatment was 23 days (range 7-59 days), with a median of 3 doses (range 1-5) per patient. GI GVHD staging was evaluated at various time points after the first vedolizumab dose, showing improvement in nine of the 13 patients. After a median follow-up time of 13 months (range 6-34 months), eight patients completely recovered, two had ongoing chronic colitis, and three patients died. During the vedolizumab treatment period, 38 infectious episodes were noted, most of them GI related. The unique activity profile of vedolizumab makes it an appealing treatment option for lower GI aGVHD, but caution for concurrent infections is warranted.
Substances chimiques
vedolizumab
9RV78Q2002
Antibodies, Monoclonal, Humanized
0
Steroids
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e30061Informations de copyright
© 2022 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.
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