Researchers at the Wroclaw Medical University in Poland investigated the use of vedolizumab for steroid-resistant (SR) gastrointestinal (GI) acute graft-versus-host disease (aGVHD) in children. Their preliminary findings, published in the journal Advances in Clinical and Experimental Medicine, demonstrate the vedolizumab may be used in children with SR GI aGVHD.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for certain hematological malignancies. Unfortunately, allo-HSCT can lead to GVHD, which can be life-threatening. As a first-line treatment for GVHD, systemic steroid therapy is used but, in ~35-50% of patients, GVHD becomes refractory to steroids. In these patients, mortality reaches 80%. Thus, the authors sought to determine if vedolizumab, an anti-inflammatory α₄β₇ integrin blocking monoclonal antibody, could be used in this context for children.
The authors followed the outcomes of three children between 8 and 10 years of age with SR GI aGVHD after allo-HSCT treated with vedolizumab. Overall, only one survived nine months after discontinuation of therapy. Among the other two, one died of lymphoma progression, and the other of GVHD. Although the sample size was limited, the authors conclude that vedolizumab can be safely used in children and may provide an additional chance of response for SR GI aGVHD.
Rosa M, Jarmoliński T, Miśkiewicz-Migoń I, et al. Vedolizumab in highly resistant acute gastrointestinal graft-versus-host disease after allogeneic stem cell transplantation: A single-center pediatric series. Adv Clin Exp Med. 2022;31(3):345-350. https://doi.org/10.17219/acem/146321