AI Article Synopsis
- - A 13-year-old boy with recurrent acute myeloid leukemia received a hematopoietic stem cell transplant (HSCT) from an unrelated donor, who had a near-perfect HLA match, except for one antigen.
- - After 42 days, the patient developed a severe liver condition (steroid-refractory hepatitic GVHD) but successfully responded to pulse cyclophosphamide (Cy) treatment, showing no changes in blood chimerism or infections.
- - Two years post-transplant, the patient remains in complete remission without chronic GVHD, indicating that pulse Cy could be an effective treatment for steroid-refractory GVHD, warranting further clinical trials.
Article Abstract
A 13-yr-old boy with recurrent acute myeloid leukemia underwent HSCT using cells from an unrelated donor who matched all HLA antigens except one. Forty-two days later, the patient developed a steroid-refractory hepatitic variant of liver GVHD with peak ALT and T.Bil values of 1406 mU/mL and 10.4 mg/dL, respectively. He was successfully treated with pulse Cy (1000 mg/dose × one day) without a change in chimerism being observed or acquiring an infection. All immunosuppressant therapies could be discontinued 12 months after HSCT. Two yr after HSCT, the patient remains in CR without chronic GVHD. This single case report suggests that pulse Cy may be a promising therapy for steroid-refractory GVHD, especially hepatitic GVHD, but needs to be further tested in clinical trials.
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| http://dx.doi.org/10.1111/j.1399-3046.2012.01664.x | DOI Listing |
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