Treatment of post transfusion graft-versus-host disease

Vox Sang. 2000:78 Suppl 2:277-9.

Abstract

Background and objectives: In Japan, so many cases of post-transfusion graft-versus-host disease (PT-GVHD) have been reported, and no effective treatment has been reported.

Results: Totally 61 cases of PT-GVHD have been collected, and their background were analyzed. A serine protease inhibitor, nafamostat mesilate(N.M.) was examined as a drug for treatment of PT-GVHD using 4 patients.

Results: N.M. was confirmed to inhibit cytotoxic activities of established cytotoxic T cell (CTL) clones in vitro. Simultaneously it was confirmed that fever and skin rash disappeared and liver function tests were normalized soon after the administration of N.M. in all four cases. Leukopenia and thrombocytopenia simultaneously improved.

Conclusion: The effects of N.M. seem to be limited to inhibit cytotoxic activity of CTL. In addition to this drug, how to remove the CTL from the patients will be the essentially important theme for the future.

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / standards
  • Benzamidines
  • Drug Evaluation
  • Female
  • Graft vs Host Disease / drug therapy*
  • Graft vs Host Disease / epidemiology
  • Graft vs Host Disease / etiology
  • Guanidines / administration & dosage
  • Guanidines / adverse effects
  • Guanidines / standards
  • Humans
  • Male
  • Middle Aged
  • Serine Proteinase Inhibitors / adverse effects
  • Serine Proteinase Inhibitors / standards
  • Serine Proteinase Inhibitors / therapeutic use
  • Transfusion Reaction*
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Benzamidines
  • Guanidines
  • Serine Proteinase Inhibitors
  • nafamostat