title: Effective use of tocilizumab for the treatment of steroid-refractory gastrointestinal acute graft versus host disease in a child with very high levels of serum interleukin-6.
abstract: Steroid-refractory acute graft versus host disease (SR-aGVHD) is associated with poor prognosis. A three year old male with severe sickle cell disease (SCD) received a 7/8 HLA-matched unrelated bone marrow transplant. He developed grade III acute graft versus host disease (aGVHD) of the gut, which was refractory to methylprednisolone and five other treatment regimens. Due to very high serum Interleukin-6 (IL-6) levels, he received salvage therapy with tocilizumab with resolution of aGVHD. It may be reasonable to further prospectively study routine monitoring of IL-6 levels and the use of tocilizumab in such patients. Pediatr Blood Cancer 2015;62:362-363. © 2014 Wiley Periodicals, Inc.
authors.affiliation: Department of Nursing, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kolb
authors.affiliation: Department of Pediatrics, Columbia University, New York, NY.
authors.forename: Monica
authors.initials: M
authors.lastname: Bhatia
authors.affiliation: Department of Nursing, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY.
authors.forename: Gay-Gaddi
authors.initials: GG
authors.lastname: Madina
authors.affiliation: Department of Pediatrics, Columbia University, New York, NY.
authors.forename: Prakash
authors.initials: P
authors.lastname: Satwani
mesh_terms: D000755:Anemia, Sickle Cell / Q000473:pathology; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002675:Child, Preschool; D006086:Graft vs Host Disease / Q000188:drug therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D010146:Pain / Q000473:pathology; D019947:Receptors, Interleukin-6 / Q000037:antagonists & inhibitors*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C508600:IL6 protein, human; C508603:IL6R protein, human; D015850:Interleukin-6; D019947:Receptors, Interleukin-6; C502936:tocilizumab
keywords: children; interleukin-6; steroid refractory acute graft versus host disease; tocilizumab