title: Intra-arterial methylprednisolone for severe steroid refractory gastrointestinal graft-versus-host disease.
abstract: Acute graft versus host disease (GVHD) is a significant complication of bone marrow transplantation with approximately half of patients being refractory to steroids. There are numerous second-line systemic immunosuppressive treatments but the overall prognosis is poor and these therapies are associated with high mortality due to infection. An alternative approach to systemic treatment for GVHD is targeted delivery of immunosuppression. We present two pediatric cases with steroid-refractory gastrointestinal GVHD who clinically responded to intra-arterial steroid administration. We also review the literature regarding this treatment modality with a particular emphasis in children.
authors: Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Kaljit S
authors: KS
authors: Bhuller
authors: Manraj K S
authors: MK
authors: Heran
authors: John K M
authors: JK
authors: Wu
authors: S Rod
authors: SR
authors: Rassekh
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D003131:Combined Modality Therapy; D004351:Drug Resistance / Q000187:drug effects*; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy* / Q000209:etiology; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007261:Infusions, Intra-Arterial; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000628:therapy; D008775:Methylprednisolone / Q000008:administration & dosage*; D011379:Prognosis; D013256:Steroids / Q000009:adverse effects*; D013789:Thalassemia / Q000150:complications* / Q000628:therapy
chemical_list: D000893:Anti-Inflammatory Agents; D013256:Steroids; D008775:Methylprednisolone
keywords: BMT; angiography; graft versus host disease; intra-arterial steroid; stem cell transplantation; transplantation