title: Gastrointestinal chronic graft-versus-host disease: management options.
abstract: Chronic graft-versus-host disease (GVHD) is a common and debilitating condition afflicting a number of allogeneic stem cell recipients more than 100 days after their transplant. Limited options are available for the acute management of patients with severe gastrointestinal (GI) symptoms including gastric bleeding. Along with increased immunosuppression and aggressive supportive care, we report here the use of aminocaproic acid in the management of patients with GI bleeding resulting from severe GVHD. The use of aminocaproic acid enabled us to reduce the frequency and number of blood product transfusions required to manage our patient. Anti-fibrinolytic agents may therefore serve as useful adjunctive but underutilized therapy in the management of patients with severe GI chronic GVHD.
authors.affiliation: Division of Hematology & Oncology, Arthur G James Cancer Hospital, Ohio State University, Columbus, OH 43210, USA. farrukh.awan@osumc.edu
authors.forename: Farrukh
authors.initials: F
authors.lastname: Awan
authors.forename: Mehdi
authors.initials: M
authors.lastname: Hamadani
mesh_terms: D000368:Aged; D000614:Aminocaproates / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D017707:Erythrocyte Transfusion; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006086:Graft vs Host Disease / Q000150:complications / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D054328:Proton Pump Inhibitors
chemical_list: D000614:Aminocaproates; D000897:Anti-Ulcer Agents; D000933:Antifibrinolytic Agents; D007166:Immunosuppressive Agents; D054328:Proton Pump Inhibitors