Use of a somatostatin analogue, octreotide acetate, in the management of acute gastrointestinal graft-versus-host disease.
OBJECTIVE
Because the secretory diarrhea of acute graft-versus-host disease (GvHD) of the gut induces serious metabolic and nutritional disturbances, this study was initiated to assess the use of a somatostatin analogue, octreotide acetate, as adjunctive therapy for severe GvHD of the gut with massive diarrhea.


METHODS
In a pilot study, six patients with biopsy-confirmed acute gut GvHD after allogeneic bone marrow transplantation received octreotide 50 to 250 micrograms three times a day subcutaneously.


RESULTS
Three of the six treated patients had a prompt and dramatic reduction in stool volume within 1 to 3 days of initiation of octreotide therapy.


CONCLUSIONS
Somatostatin and its analogues have been used successfully in diarrheal states by antagonism of neuropeptide overproduction, although other potential therapeutic mechanisms include inhibition of fluid secretion, enhanced salt absorption, and inhibition of gut motility. Somatostatin and its analogues may be promising adjunctive agents in the treatment of gastrointestinal GvHD, although assessment in a controlled trial will be required to confirm their therapeutic efficacy.
Ely
P
P
Department of Medicine, University of Minnesota Hospital, Minneapolis.
Dunitz
J
J
Rogosheske
J
J
Weisdorf
D
D
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D003967:Diarrhea / Q000188:drug therapy* / Q000209:etiology; D004334:Drug Administration Schedule; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007410:Intestinal Diseases / Q000188:drug therapy* / Q000209:etiology; D015282:Octreotide / Q000627:therapeutic use*; D010865:Pilot Projects
D015282:Octreotide