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Influence of oral beclomethasone dipropionate on early non-infectious pulmonary outcomes after allogeneic hematopoietic cell transplantation: results from two randomized trials
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Influence of oral beclomethasone dipropionate on early non-infectious pulmonary outcomes after allogeneic hematopoietic cell transplantation: results from two randomized trials
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Influence of oral beclomethasone dipropionate on early non-infectious pulmonary outcomes after allogeneic hematopoietic cell transplantation: results from two randomized trials
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Journal Article
Influence of oral beclomethasone dipropionate on early non-infectious pulmonary outcomes after allogeneic hematopoietic cell transplantation: results from two randomized trials
2010
Overview
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.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Aged
/ Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
/ Atria
/ Beclomethasone - analogs & derivatives
/ Beclomethasone - therapeutic use
/ Biological and medical sciences
/ Blood
/ Bone marrow, stem cells transplantation. Graft versus host reaction
/ 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
/ Medicine
/ Patients
/ Placebos
/ Respiratory system : syndromes and miscellaneous diseases
/ Transfusions. Complications. Transfusion reactions. Cell and gene therapy
