title: Recombinant human tumor necrosis factor receptor fusion protein as complementary treatment for chronic graft-versus-host disease.
abstract: BACKGROUND
  Chronic graft-versus-host disease (cGVHD) remains one of the major late complications in allogeneic bone marrow transplantation (BMT). Prolonged immunosuppression often results in significant morbidity and mortality. Cytokine dysregulation is implicated in the pathophysiology of cGVHD, and tumor necrosis factor-alpha (TNF-alpha) plays a central role.
  
  
  METHODS
  Recombinant soluble TNF receptor (Enbrel) was explored for the use of steroid-dependent cGVHD in 10 patients. Enbrel was given as a subcutaneous injection twice weekly for 4 weeks followed by once weekly for 4 more weeks. Progression or regression of cGVHD was monitored closely by regular clinical follow-up.
  
  
  RESULTS
  Eight patients finished the 8-week treatment course without adverse side effect. Seven of them showed improvement (subjectively and/or objectively) in cGVHD. Steroid taper was initiated as early as 1 month.
  
  
  CONCLUSIONS
  This preliminary encouraging result merits additional studies to optimize Enbrel as a potential complementary therapy for resolution of steroid-dependent cGVHD.
authors.affiliation: Division of Transplantation Medicine, Palmetto Richland Memorial Hospital South Carolina Cancer Center, Columbia, South Carolina 29203, USA. kuang-yueh.chiang@choa.org.
authors.forename: Kuang-Yueh
authors.initials: KY
authors.lastname: Chiang
authors.forename: Sunil
authors.initials: S
authors.lastname: Abhyankar
authors.forename: Kerry
authors.initials: K
authors.lastname: Bridges
authors.forename: Kamar
authors.initials: K
authors.lastname: Godder
authors.forename: Jean P
authors.initials: JP
authors.lastname: Henslee-Downey
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000276:immunology*; D002908:Chronic Disease; D000068800:Etanercept; D006086:Graft vs Host Disease / Q000188:drug therapy*; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D014184:Transplantation, Homologous
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins; D000068800:Etanercept