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. 2022 Jul;38(3):601-605.
doi: 10.1007/s12288-022-01524-2. Epub 2022 Feb 7.

Alpha-1-Antitrypsin Experience for Steroid-Resistant Acute Graft-Versus-Host Disease

Derya Koyun  1 , Güldane Cengiz Seval  1 , Ekin Kırcalı  1 , Sinem Civriz Bozdağ  1 , Selami Koçak Toprak  1 , Pervin Topçuoğlu  1 , Muhit Özcan  1 , Önder Arslan  1 , Taner Demirer  1 , Osman İlhan  1 , Meral Beksaç  1 , Günhan Gürman  1 , Meltem Kurt Yüksel  1
Affiliations

Alpha-1-Antitrypsin Experience for Steroid-Resistant Acute Graft-Versus-Host Disease

Derya Koyun et al. Indian J Hematol Blood Transfus. 2022 Jul.

Abstract

Steroid-refractory acute graft-versus-host disease (SR-aGVHD) treatment has a low response rate and a high risk of infection in allogeneic hematopoietic stem cell transplantation. The standard approach to be applied in this situation is uncertain. This study aims to evaluate the effectiveness and safety of alpha-1-antitrypsin (AAT). In the study, the results of five SR-aGVHD patients received AAT evaluated. Complete response was seen 2 of four patients with gastrointestinal (GI) aGVHD, partial response in one GI and one liver aGVHD. The overall response rate was 80%. AAT is an effective and safe treatment option in SR-aGVHD.

Keywords: AAT; SR-aGVHH.

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Conflict of interest statement

Conflict of interestAll authors have no conflinct of interest.

Figures

Fig. 1
Fig. 1
Treatment line before and after AAT. Day 0 aGVHD day one. (formula image) AAT, (formula image) Stopped treatment (formula image) Mycophenolate mofetil + Methylprednısalone, (formula image) Ruxolıtınib (Rx), (formula image) Mesenchymal stem cell, (formula image) ECP, Posterior reversible encephalopathy syndrome (PRES), B-ALL (B acute lymphoblastic leukemia) Relaps aGVHD occured in patient 3 and 5. Patient 3: Treated with tacrolımus + Rx for past GVHD. Patient 5: CsA replaced to sirolimus for thrombotic microangiopathy. Later on sirolimus stopped
Fig. 2
Fig. 2
AAT level change. (Normal range 0.88–1.74 gr/dl). Patient 5: Non-applicable (N/A)
See this image and copyright information in PMC

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