Etanercept for steroid-refractory acute graft-versus-host disease: A single center experience

De Jong, Cornelis N.; Saes, Lotte; Klerk, Clara P. W.; Van der Klift, Marjolein; Cornelissen, Jan J.; Broers, Annoek E. C.

Irrespective of response and survival rates, the rate of significant infectious complications is high in all reported studies. We report infectious complications in 81.3% of the patients. In 40% of patients, death was attributable to an infectious complication. The risk of opportunistic infections is known to be high in SR-aGVHD, due to the strong immunosuppressive regimen imposed on a frail, recovering post-transplant immune system. Anti-TNFα agents, in particular, are associated with a high incidence of opportunistic infections [15] . Moreover, the use of CB derived stem cells in four patients might have contributed, as transplantation of CB derived stem cells, in particular, is associated with delayed immune reconstitution [16] . Therefore, adequate monitoring and prophylaxis of infections is important.