Use of octreotide in the symptomatic management of diarrhea induced by graft-versus-host disease in patients with hematologic malignancies.

Ippoliti, Cindy; Champlin, Richard E.; Bugazia, Najla; Przepiorka, Donna; Neumann, Joyce; Giralt, Sergío; Khouri, Issa F.; Gajewski, James

doi:10.1200/jco.1997.15.11.3350

Cited by 46 publications

(30 citation statements)

References 16 publications

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“…Octreotide [3][4][5] This somatostatin analogue has a documented effect on diarrhoea and can be used as an adjuvant in gastrointestinal GVHD. The effect is often prompt, and is exerted through antagonism of neuropeptides in the gut, thus counteracting gut hypermotility and hypersecretion.…”

Section: Mesenchymal Stem Cells (Msc)mentioning

confidence: 99%

“…Recent additions to the therapeutic arsenal include somatostatin analogues (octreotide) [3][4][5] ; monoclonal antibodies against cytokines involved in GVHD, mainly TNF-alpha and IL-2; PUVA (psoralen-enhanced UVA irradiation) 6 , extracorporeal photochemotherapy/PUVA (ECP) 7 and the use of third party expanded immunomodulatory cells. 8 A few of these are discussed below.…”

Section: Refractory Acute Gvhdmentioning

confidence: 99%

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Novel approaches in GVHD therapy

Svennilson

2005

Bone Marrow Transplant

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Summary:Severe graft-versus-host disease is a lethal complication to allogeneic haemopoietic stem cell transplantation. This short review gives an overview of novel treatment strategies. Psoralen-enhanced UVA irradiation (PUVA), extracorpoal PUVA, antibodies against IL-2 and TNFalpha, thalidomide, octreotide, and mesenchymal stem cells are briefly discussed. Bone Marrow Transplantation (2005) 35, S65-S67.

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Section: Mesenchymal Stem Cells (Msc)mentioning

confidence: 99%

Section: Refractory Acute Gvhdmentioning

confidence: 99%

Novel approaches in GVHD therapy

Svennilson

2005

Bone Marrow Transplant

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“…anti-human thymocyte antibodies (ATG, ALG); monoclonal antibodies (eg IL2-receptor AB, 31 OKT3, 32 LFA-1mAB 33 ); mycophenolate mofetil; 34 octreotid (in gut GVHD); 35,36 extracorporeal photopheresis. 37 …”

Section: Additional Drugs As Options For Second-line Treatmentmentioning

confidence: 99%

Statement of current majority practices in graft-versus-host disease prophylaxis and treatment in children

Peters

Minkov

Gadner

et al. 2000

Bone Marrow Transplant

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Summary:Great variations exist in the prophylaxis and treatment of GVHD in children undergoing allogeneic stem cell transplantation (SCT). The EBMT Working Party Paediatric Diseases (EBMT-WP PD) and the International BFM Study Group -Subcommittee Bone Marrow Transplantation (IBFM-SG), aimed at evaluating current local standards in the prevention and treatment of GVHD and steps which can be taken to achieve a uniform policy for the individual methods. Several conferences with their members assessed practices which are mainly applied or under investigation in children and identified where additional information is needed. For prevention of GVHD, the majority of the paediatric centres prefer CsA ± MTX. Addition of folinic acid to MTX was considered for reduction of side-effects. During treatment of acute GVHD most centres administer prednisolone and whole blood level-adjusted CsA as medications of first choice. In cases of poor or no response to this therapy, additional immunosuppressive agents such as ATG, mycophenolate-mofetile and tacrolimus are being increasingly used. The treatment of chronic GVHD usually consists of various combinations of prednisolone and CsA. In severe cases, extracorporeal photopheresis, psoralene-UVA (PUVA) and thalidomide are administered. Bone Marrow Transplantation (2000) 26, 405-411. Keywords: graft-versus-host disease; prophylaxis; therapy; children; allogeneic bone marrow transplantation Graft-versus-host disease (GVHD) is still a major complication after allogeneic stem cell transplantation (SCT) and has a remarkable influence on the outcome of this procedure.Although younger subjects tend to develop GVHD less The most effective approaches to prevent GVHD are lymphocyte depletion to remove effector cells from the graft, and separation of T cells from other accessory cells. However, these methods may result in increased engraftment failure and a weaker graft-versus-leukaemia (GVL) effect. 4 Thus, many paediatric SCT centres prefer GVHD prophylaxis by pharmacological means, using single or multiple immunosuppressive drugs. 5 In patients with malignant diseases, a major goal of allogeneic SCT is the immunologic GVL effect. 6 To maximise this reaction, it has been attempted to adapt GVHD prophylaxis to the needs of individual patients. 7,8 Therefore, it is not surprising that many groups have developed individual protocols for the prevention and therapy of GVHD which renders an interpretation of pooled patient data difficult. [9][10][11] Response to primary GVHD therapy is one of the most important predictors of long-term survival. 12 Furthermore, in young children the impact of optimal GVHD therapy is important because the growing organism is vulnerable to the consequences of GVHD itself. 13,14 So far only very few studies have been able to provide information about the efficacy of various therapeutic modalities used for the treatment of acute and chronic GVHD in childhood. [15][16][17][18] Therefore, the members of the EBMT Working Party pediatric diseases (WP-PD) and of the Internat...

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“…However, there is yet no proven effect of octreotide in Treatment with octreotide resulted in a response rate between 50 and 100% in three uncontrolled studies includthe treatment of chemotherapy-induced diarrhea. Fur- Fried ing 6-24 patients [24][25][26][27]. In the largest study with an duced the duration of diarrhea but not stool volumes [34].…”

Section: Graft-versus-host Diseasementioning

confidence: 99%

“…In the largest study with an duced the duration of diarrhea but not stool volumes [34]. 85% response rate, a high dose of octreotide (1,500 g/ day) was employed [24].…”

Section: Graft-versus-host Diseasementioning

confidence: 99%

Octreotide in the Treatment of Refractory Diarrhea

Fried

1999

Digestion

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Refractory chronic diarrhea that does not respond to specific antimicrobial therapy or standard unspecific medication may present a challening and serious clinical problem. Octreotide is a candidate drug for the treatment of these patients as it inhibits gastrointestinal motility, pancreatic secretion and inhibits intestinal absorption. Only few mostly uncontrolled studies in small patient groups were published evaluating the efficacy of octreotide in the treatment of patients with chemotherapy-induced diarrhea, short-bowel syndrome, AIDS-associated diarrhea and other conditions with chronic diarrhea not responding to standard treatment. Most of these studies are not conclusive as they yielded either negative or controversial results. Octreotide may be tried in the treatment of refractory diarrhea, in particular AIDS-associated diarrhea if patients do not respond to conventional treatment strategies. Well-designed controlled trials in large patient groups are needed in order to define the place of octreotide in the treatment of patients with refractory diarrhea.

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Use of octreotide in the symptomatic management of diarrhea induced by graft-versus-host disease in patients with hematologic malignancies.

Cited by 46 publications

References 16 publications

Novel approaches in GVHD therapy

Novel approaches in GVHD therapy

Statement of current majority practices in graft-versus-host disease prophylaxis and treatment in children

Octreotide in the Treatment of Refractory Diarrhea

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