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.

Acute GVHD: Prophylaxis, diagnosis, treatment and response criteria Standard aGVHD prophylaxis for all allograft recipients included cyclosporin A (CsA) and mycophenolic acid (MPA) or its prodrug mycophenolate mofetil (MMF). In case of a 7/8 HLA matched MUD, anti-thymocyte globulin (ATG) was added to the conditioning regimen. Levels of CsA were measured by high performance liquid chromatography on whole blood samples and aimed at trough levels of 250-350 μg/L. Acute GVHD was graded according to the modified Glucksberg criteria [12] , and the diagnosis of aGVHD was preferably confirmed by histology of involved tissues. First-line treatment for grade II to IV aGVHD consisted of prednisolone 2mg/kg/day and CsA or MPA/MMF. Grade I aGVHD was treated with topical steroids.