Steroid myopathy in patients with acute graft-versus-host disease treated with high-dose steroid therapy.
High-dose steroids are the first line of treatment for acute graft-versus-host disease (aGVHD). Steroid myopathy is a debilitating steroid-induced complication that significantly impairs a patient's performance status. To determine the frequency and severity of steroid myopathy and other steroid related complications in patients with acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS) who developed grade >or=2 aGVHD after allogeneic hematopoietic stem cell transplantation (HSCT), we performed a retrospective analysis. Patients were included in the analysis if they had a diagnosis of AML/MDS, underwent an allogeneic HSCT between January 1996 and December 2001 and developed grade >or=2 aGVHD that was treated with 2 mg/kg of methylprednisolone and survived at least 100 days post transplant. A total of 70 patients fulfilled our inclusion criteria. Steroid myopathy was identified in 29 (41%) patients. Steroid myopathy was generally of moderate severity with severe debilitating steroid myopathy seen in only 3% of patients. We concluded that steroid myopathy is a common complication of high-dose steroid therapy after allogeneic HSCT in AML/MDS. Interventions aimed at preventing and treating this complication are warranted and need to be explored in prospective clinical trials.
Lee
H J
HJ
University at Buffalo School of Medicine, Buffalo, NY, USA.
Oran
B
B
Saliba
R M
RM
Couriel
D M
DM
Shin
K
K
Massey
P
P
Neumann
J
J
de Lima
M
M
Champlin
R
R
Giralt
S
S
D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications* / Q000188:drug therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007951:Leukemia, Myeloid / Q000150:complications / Q000628:therapy; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000633:toxicity; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced*; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000628:therapy; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage / Q000633:toxicity*
D013256:Steroids; D008775:Methylprednisolone