Background: Graft versus host disease (GVHD) is a complex disease resulting from donor T-cell recognition of a genetic disparate recipient, which is unable to reject donor cells after allogeneic transplant. Glucocorticoids (steroids) are the mainstay of acute GVHD therapy. Glucocorticoid resistance has been characterized in several inflammatory conditions including asthma, rheumatoid arthritis, systemic lupus, erythematosus, ulcerative colitis, and Crohns disease. Glucocorticoid resistance has also been seen in a subset of patients with GVHD. However, to date, the biology of this steroid refractoriness in the treatment of GVHD has not been examined.
Objective and hypotheses: We propose to study the steroid sensitivity of bone marrow transplanted patients and their related donors using a Fluorescein labelled dexamethasone (F-DEX) monocyte binding assay to help in the treatment of these patients.
Method: Collection of pre- and post-BMT blood samples from 20 patient/donor pairs who plan to undergo allogeneic bone marrow transplant. The samples will be analysed using a F-DEX monocyte binding assay of collected monocytes.
Results: Currently preliminary results are being ascertained.
Conclusion: We hope that the data collected from these patients will help to examine steroid sensitivity in these patients and help to design better treatment strategies for these patients.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology