Titre :

Diverting Enterostomy Improves Overall Survival of Patients with Severe Steroid-Refractory Gastrointestinal Acute Graft-versus-host Disease

Auteur(s) :

Khodr, J. [Auteur]
Zerbib, Philippe [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Rogosnitzky, Moshe [Auteur]
Magro, L. [Auteur]
Truant, Stéphanie [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Yakoub-Agha, Ibrahim [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Seguy, David [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Titre de la revue :

Annals of Surgery

Nom court de la revue :

Ann Surg

Numéro :

274

Pagination :

p. 773-779

Date de publication :

2021-11

ISSN :

1528-1140

Mot(s)-clé(s) en anglais :

acute graft-versus-host disease
allogeneic hematopoietic stem cell transplantation
enterostomy
overall survival
small bowel

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Objective: The aim of this study was to evaluate the benefit of diverting enterostomy (DE) in patients with severe steroid-refractory (SR) gastrointestinal acute graft-versus-host-disease (GI-aGVHD) following allogeneic ...
Lire la suite >Objective: The aim of this study was to evaluate the benefit of diverting enterostomy (DE) in patients with severe steroid-refractory (SR) gastrointestinal acute graft-versus-host-disease (GI-aGVHD) following allogeneic hematopoietic stem-cell transplantation (ASCT). Summary and Background Data: Severe GI-aGVHD refractory to the first-line steroid therapy is a rare but dramatic life-threatening complication. Second lines of immunosuppressors have limited effects and increase the risk of sepsis. Data suggest that limiting GI bacterial translocation by DE could restrain severe GI-aGVHD. Methods: From 2004 to 2018, we retrospectively reviewed all consecutive patients undergoing ASCT for hematologic malignancies who developed severe SR GI-aGVHD. We compared patients in whom a proximal DE was performed (Enterostomy group) with those not subjected to DE (Medical group). The primary endpoint was the 1-year overall survival (OS) measured from the onset of GI-aGVHD. Secondary endpoints were the 2-year OS and causes of death. Results: Of the 1295 patients who underwent ASCT, 51 patients with severe SR GI-aGVHD were analyzed (13 in Enterostomy group and 38 in Medical group). Characteristics of patients, transplantation modalities, and aGVHD severity were similar in both groups. The 1-year OS was better after DE (54% vs 5%, P = 0.0004). The 2-year OS was also better in “Enterostomy group” (31% vs 2.5%; P = 0.0015), with a trend to lower death by sepsis (30.8% vs 57.9%; P = 0.091). Conclusion: DE should be considered for severe GI-aGVHD as soon as resistance to the corticosteroid is identified.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
• Lille Neurosciences & Cognition (LilNCog) - U 1172
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2023-11-15T06:07:00Z
2024-04-10T09:24:34Z