Chien, Jason W. and Sakai, Miwa and Gooley, Ted A. and Schoch, H. Gary and McDonald, George B. (2010) Influence of oral beclomethasone dipropionate on early non-infectious pulmonary outcomes after allogeneic hematopoietic cell transplantation: results from two randomized trials. Bone marrow transplantation, 45. pp. 317-324. ISSN 1476-5365
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Abstract
Early non-infectious pulmonary complications represent a significant cause of mortality after hematopoietic cell transplantation (HCT). We tested the hypothesis that oral beclomethasone dipropionate (BDP) is effective for preventing early non-infectious pulmonary complications after allogeneic HCT. We retrospectively reviewed the medical records of 120 patients, 60 in each treatment arm, to identify non-infectious and infectious pulmonary events and pulmonary function test results from all patients who participated in two randomized trials of oral BDP for treatment of acute gastrointestinal GVHD. 17-Beclomethasone monopropionate (17-BMP), the active metabolite of BDP, was evaluated in blood from the right atrium in four patients. Thirty-three of 42 (79%) placebo-treated patients experienced a decrease of the DL(CO) from pretransplant to day 80 after transplant, compared with 27 of 49 (55%) BDP-treated patients (P=0.02). In the first 200 days after randomization, there were no cases of non-infectious pulmonary complications in BDP-treated patients, vs four cases among placebo-treated patients (P=0.04). Levels of 17-BMP were detected in atrial blood at steady state. Delivery of a potent glucocorticoid such as 17-BMP to the pulmonary artery after oral dosing of BDP may be useful in modulating pulmonary inflammation and preventing the development of non-infectious pulmonary complications after allogeneic HCT.Bone Marrow Transplantation advance online publication, 29 June 2009; doi:10.1038/bmt.2009.129.
| Item Type: | Article or Abstract |
|---|---|
| Additional Information: | This article is available to subscribers only via the URL above. |
| DOI: | 10.1038/bmt.2009.129 |
| PubMed ID: | 19561649 |
| NIHMSID: | NIHMS135853 |
| PMCID: | PMC2820152 |
| Grant Numbers: | P01 CA018029, P30 CA015704- |
| Keywords or MeSH Headings: | * Adolescent * Aged * Beclomethasone/analogs & derivatives * Beclomethasone/blood * Beclomethasone/metabolism * Beclomethasone/therapeutic use* * Child * Female * Graft vs Host Disease/drug therapy* * Hematopoietic Stem Cell Transplantation/adverse effects * Humans * Lung Diseases/chemically induced * Lung Diseases/drug therapy* * Lung Diseases, Fungal/etiology * Male * Middle Aged * Respiratory Function Tests |
| Subjects: | Therapeutics > Transplantation > Stem Cell transplantation Therapeutics > Drug Therapy |
| Depositing User: | Library Staff |
| Date Deposited: | 31 Jul 2009 16:17 |
| Last Modified: | 14 Feb 2012 14:42 |
| URI: | http://authors.fhcrc.org/id/eprint/320 |
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