Vedolizumab in highly resistant acute gastrointestinal graft-versus-host disease after allogeneic stem cell transplantation: A single-center pediatric series

Rosa, Monika; Jarmoliński, Tomasz; Miśkiewicz-Migoń, Izabella; Liszka, Karolina; Miśkiewicz‐Bujna, Justyna; Panasiuk, Anna; Frączkiewicz, Jowita; Ussowicz, Marek

doi:10.17219/acem/146321

Cited by 5 publications

(4 citation statements)

References 38 publications

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“…In this study, only one patient had non‐GI manifestations, and all patients rapidly achieved durable clinical response and gradual histologic improvement. A similar response profile was reported in a few cases of pediatric patients published so far 10–13 . However, other case series that included adult patients with more severe disease, and with concurrent skin and liver involvement, showed less encouraging results 19,20 .…”

Section: Discussionsupporting

confidence: 79%

“…Evidence of safety and efficacy of this modality for treating GI GVHD in children is scarce with only one case report and three case series recently published. [10][11][12][13] In this study, we present our experience in treating thirteen pediatric patients with vedolizumab for GI aGVHD. Acute GVHD International Consortium (MAGIC) staging criteria.…”

Section: Stagementioning

confidence: 99%

“…A similar response profile was reported in a few cases of pediatric patients published so far. [10][11][12][13] However, other case series that included adult patients with more severe disease, and with concurrent skin and liver involvement, showed less encouraging results. advantageous in these high-risk patients, where immune suppression may hamper the desirable graft-versus-leukemia effect.…”

Section: Chryseobacterium Gambrini 1 (Blood)mentioning

confidence: 99%

“…Following recent reports of safe and efficacious treatment with vedolizumab for adult patients with aGVHD and reports of successful treatment in children with IBD, we started to treat selected pediatric patients, who presented with predominant GI manifestations of aGVHD, with vedolizumab. Evidence of safety and efficacy of this modality for treating GI GVHD in children is scarce with only one case report and three case series recently published 10–13 . In this study, we present our experience in treating thirteen pediatric patients with vedolizumab for GI aGVHD.…”

Section: Introductionmentioning

confidence: 96%

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Vedolizumab for pediatric patients with gastrointestinal acute graft‐versus‐host‐disease

Bier

Zaidman

Schejter

et al. 2022

Pediatric Blood & Cancer

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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 graftversus-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.

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Section: Discussionsupporting

confidence: 79%