Targeting Integrin α4β7 in Steroid-Refractory Intestinal Graft-versus-Host Disease

Yngvar Fløisand; Knut E A Lundin; Vladimir Lazarevic; Jørn Dehli Kristiansen; Liv T N Osnes; Geir E Tjønnfjord; Henrik Mikael Reims; Tobias Gedde-Dahl

doi:10.1016/j.bbmt.2016.10.009

Targeting Integrin α4β7 in Steroid-Refractory Intestinal Graft-versus-Host Disease

Biol Blood Marrow Transplant. 2017 Jan;23(1):172-175. doi: 10.1016/j.bbmt.2016.10.009. Epub 2016 Oct 21.

Authors

Yngvar Fløisand¹, Knut E A Lundin², Vladimir Lazarevic³, Jørn Dehli Kristiansen⁴, Liv T N Osnes⁵, Geir E Tjønnfjord⁶, Henrik Mikael Reims⁷, Tobias Gedde-Dahl⁴

Affiliations

¹ Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: yfl70@me.com.
² Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Department of Gastroenterology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Centre for Immune Regulation, University of Oslo, Oslo, Norway.
³ Department of Hematology and Oncology, Skåne University Hospital, Lund, Sweden.
⁴ Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
⁵ Department of Immunology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
⁶ Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁷ Department of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

PMID: 27777142
DOI: 10.1016/j.bbmt.2016.10.009

Abstract

Steroid refractory acute graft-versus-host-disease of the gut is a serious complication associated with high mortality after allogeneic stem cell transplantation. Treatment options are limited and not predictably effective. We describe the treatment of steroid-refractory acute graft-versus-host-disease with vedolizumab, an antibody directed against integrin α4β7, in 6 patients. All patients responded, and 4 of 6 patients are alive with a median follow-up of 10 months.

Keywords: Graft-versus-host disease; Gut GVHD; Integrin; Stem cell transplant; Steroid refractory; Vedolizumab.

MeSH terms

Adult
Antibodies, Monoclonal, Humanized / therapeutic use*
Female
Gastrointestinal Agents / therapeutic use
Graft vs Host Disease / drug therapy*
Graft vs Host Disease / pathology
Hematopoietic Stem Cell Transplantation / adverse effects
Humans
Integrins / drug effects*
Intestinal Diseases / drug therapy*
Male
Middle Aged
Salvage Therapy / methods
Steroids / therapeutic use
Transplantation, Homologous
Treatment Outcome

Substances

Antibodies, Monoclonal, Humanized
Gastrointestinal Agents
Integrins
Steroids
integrin alpha4beta7
vedolizumab