title: Dexamethasone palmitate successfully attenuates hemophagocytic syndrome after allogeneic stem cell transplantation: macrophage-targeted steroid therapy.
abstract: Hemophagocytic syndrome (HPS) induced by uncontrolled macrophage activation and subsequent graft failure is a frequent and prominent complication after allogeneic stem cell transplantation (allo-SCT), a cause of severe morbidity and death, and a therapeutic challenge. Liposome-incorporated dexamethasone, dexamethasone palmitate (DP), shows greater efficacy against macrophages as compared to dexamethasone sodium phosphate (DSP). Based on our findings that DP achieves significantly larger decrease than DSP on the viability of primary human macrophages compared in vitro, we tested the effects of DP in patients with HPS. A decrease in number of macrophages in the bone marrow and prevention of engraftment failure were observed in all patients without any severe complications. In conclusion, these data provide a rationale for testing DP as a first-line treatment for patients with HPS after allo-SCT.
authors.affiliation: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan. n-3104@tf7.so-net.ne.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishiwaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakayama
authors.forename: Makoto
authors.initials: M
authors.lastname: Murata
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nishida
authors.forename: Kyoko
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Shigeki
authors.initials: S
authors.lastname: Saito
authors.forename: Tomonori
authors.initials: T
authors.lastname: Kato
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mizuno
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Imahashi
authors.forename: Aika
authors.initials: A
authors.lastname: Seto
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Ozawa
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Goto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Koyama
authors.forename: Emi
authors.initials: E
authors.lastname: Yokohata
authors.forename: Naomi
authors.initials: N
authors.lastname: Kubota
authors.forename: Sonoko
authors.initials: S
authors.lastname: Kamoshita
authors.forename: Koichi
authors.initials: K
authors.lastname: Miyamura
authors.forename: Kimikazu
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ito
authors.forename: Tomoki
authors.initials: T
authors.lastname: Naoe
mesh_terms: D000328:Adult; D002470:Cell Survival / Q000187:drug effects; D002478:Cells, Cultured; D003907:Dexamethasone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D008264:Macrophages / Q000187:drug effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014184:Transplantation, Homologous
chemical_list: D005938:Glucocorticoids; C035081:dexamethasone 21-palmitate; D003907:Dexamethasone