title: Etanercept (Enbrel) administration for idiopathic pneumonia syndrome after allogeneic hematopoietic stem cell transplantation.
abstract: Acute pulmonary dysfunction remains a frequent and severe complication of hematopoietic stem cell transplantation (SCT). Almost half of the pulmonary insults that occur in this seating are noninfectious in origin and are referred to as idiopathic pneumonia syndrome (IPS). In this series of 3 patients, etanercept (Enbrel; Immunex, Seattle, WA), a soluble, dimeric tumor necrosis factor alpha-binding protein, was administered to 3 consecutive pediatric allogeneic BMT recipients with IPS. The administration of etanercept, in combination with standard immunosuppressive therapy, was well tolerated and associated with significant improvements in pulmonary dysfunction within the first week of therapy. These data suggest that etanercept may represent a safe, non-cross-reactive, therapeutic option for patients with IPS and that clinical trials studying etanercept for this indication are warranted.
authors.affiliation: Department of Pediatrics, University of Michigan Cancer Center and Mott Children's Hospital, Ann Arbor 48109-0942, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Yanik
authors.forename: Beth
authors.initials: B
authors.lastname: Hellerstedt
authors.forename: Joseph
authors.initials: J
authors.lastname: Custer
authors.forename: Raymond
authors.initials: R
authors.lastname: Hutchinson
authors.forename: Deborah
authors.initials: D
authors.lastname: Kwon
authors.forename: James L M
authors.initials: JL
authors.lastname: Ferrara
authors.forename: Joseph
authors.initials: J
authors.lastname: Uberti
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Cooke
mesh_terms: D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D004338:Drug Combinations; D004341:Drug Evaluation; D000068800:Etanercept; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D011014:Pneumonia / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D012129:Respiratory Function Tests; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept