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Use of belatacept as alternative graft vs host disease prophylaxis in pediatric allogeneic hematopoietic stem cell transplantation
Author(s) -
Wright Mariah,
Rangarajan Hemalatha,
AbuArja Rolla,
Auletta Jeffery J.,
Lee Dean,
Polishchuk Veronika,
Pai Vinita,
Taylor Kimberly,
Bajwa Rajinder P.S.
Publication year - 2021
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.14041
Subject(s) - medicine , belatacept , thrombotic microangiopathy , calcineurin , hematopoietic stem cell transplantation , graft versus host disease , transplantation , immunology , sirolimus , disease , kidney transplantation , kidney transplant
Background Immunosuppressive prophylaxis is usually given to decrease the development of acute graft versus host disease (GvHD) after allogeneic hematopoietic stem cell transplantation (HSCT). Belatacept is a Cytotoxic T‐lymphocyte‐associated protein 4, blocking agent, an immunosuppressive agent used for organ rejection prevention in adult renal transplant recipients. Methods We describe two children in whom belatacept was successfully used for GvHD prophylaxis. Case 1 was noncompliant with prior immunosuppressive therapy for aplastic anemia, and Case 2 developed severe thrombotic microangiopathy (TMA) precluding the use of calcineurin inhibitors (CNI) or mTOR inhibitors. Results and Conclusion Belatacept was found to be a safe alternative in preventing GvHD in 2 patients in whom traditional prophylactic therapies were not possible to use.