Dexamethasone palmitate successfully attenuates hemophagocytic syndrome after allogeneic stem cell transplantation: Macrophage-targeted steroid therapy

Satoshi Nishiwaki, Shigeki Saito, Tatsunori Goto, Koichi Miyamura, Takayuki Nakayama, Tomonori Kato, Daisuke Koyama, Makoto Murata, Hiroki Mizuno, Emi Yokohata, Kimikazu Matsumoto, Tetsuya Nishida, Nobuhiko Imahashi, Naomi Kubota, Masafumi Ito, Kyoko Sugimoto, Aika Seto, Yukiyasu Ozawa, Sonoko Kamoshita, Tomoki Naoe

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

Abstract

Hemophagocytic syndrome (HPS) induced by uncontrolled macrophage activation and subsequent graft failure is a frequent and prominent complication after allogeneic stem cell transplantation (allo-SCT), a cause of severe morbidity and death, and a therapeutic challenge. Liposomeincorporated dexamethasone, dexamethasone palmitate (DP), shows greater efficacy against macrophages as compared to dexamethasone sodium phosphate (DSP). Based on our findings that DP achieves significantly larger decrease than DSP on the viability of primary human macrophages compared in vitro, we tested the effects of DP in patients with HPS. A decrease in number of macrophages in the bone marrow and prevention of engraftment failure were observed in all patients without any severe complications. In conclusion, these data provide a rationale for testing DP as a firstline treatment for patients with HPS after allo-SCT.

Original languageEnglish
Pages (from-to)428-433
Number of pages6
JournalInternational Journal of Hematology
Volume95
Issue number4
DOIs
Publication statusPublished - 04-2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology

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