Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018133 (graft-versus-host disease)
 18,032 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the use of octreotide in 10 patients with severe diarrhea, refractory to loperamide, following bone marrow transplantation (BMT). Five patients had regime-related toxicity (RRT) and 5 were suffering from acute intestinal graft versus host disease (GvHD). Complete responses were observed for all patients with RRT, with optimal response being observed in the patients with dose escalation to 250 micrograms tds. Only partial responses were observed in the patients with intestinal GvHD. Increased doses of systemically administered cyclosporin-A (CSA) were necessary to maintain therapeutic levels for 2 patients. Octreotide is very effective in controlling RRT diarrhea. It is less effective in the control of GvHD-related diarrhea. CSA levels require close monitoring, whether the drug is administered systemically or orally.
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PMID:Efficacy of octreotide in controlling refractory diarrhea following bone marrow transplantation. 754 62

Octreotide inhibits intestinal motility and secretions of the gastro-intestinal tract and pancreas and mediators of diarrhoea and so is very useful in managing refractory diarrhoea. It is safe and effective in 75-80% of the 10-20% of cancer chemotherapy patients who develop severe diarrhoea, and is useful in the management of persistent diarrhoea associated with neuroendocrine tumours, particularly VIPoma and carcinoid tumours, congenital microvillus atrophy, some patients with the short bowel syndrome (giving them a reduced need for intravenous fluids), and AIDS-related diarrhoea that does not respond to antibiotics or conventional anti-diarrhoeal drugs. Some studies suggest a 50% effectiveness in graft-versus-host disease. Preliminary studies suggest that octreotide is also of value in persistent diarrhoea caused by neuromuscular disorders of the gut, particularly diabetes mellitus and systemic sclerosis, suggesting that it may have wider application in the future. Octreotide may prove useful as a tool for studying the pathogenesis of diarrhoea of diverse aetiologies, particularly those associated with disturbances of intestinal motility, such as irritable bowel syndrome.
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PMID:The role of somatostatin analogues in the treatment of refractory diarrhoea. 881 86

Octreotide appears to have a major therapeutic effect in the management of diarrhoea related to cancer therapy. This effect is seen in the acute diarrhoea following radiation therapy and chemotherapy, and also in late radiation enteritis. As well as providing improved symptom control, early treatment can prevent potentially important morbidity in patients who are vulnerable to infection and fluid loss. Patients who suffer diarrhoea as a complication of AIDS, graft-versus-host disease and tumour-related diarrhoea can also obtain major benefit from treatment with octreotide. It should be considered as a first-line treatment in patients for whom diarrhoea may be a serious complication.
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PMID:Octreotide in the management of treatment-related diarrhoea. 882 80

This report describes the use of octreotide, a synthetic somatostatin analogue, for severe diarrhea caused by acute intestinal graft-versus-host disease (GVHD) after bone marrow transplantation. A 22-month-old boy suffered grade 4 intestinal GVHD, with profuse diarrhea, intestinal inflammation, and grossly bloody stools after matched, unrelated donor transplant for biphenotypic leukemia. He required intensive blood product support. In addition to aggressive anti-GVHD therapy, octreotide acetate was initiated at 30 microg (2 microg/kg) intravenously 3 times per day and escalated to continuous infusion at 15 microg/hr (1 microg/kg per hour). The diarrhea did not improve with anti-GVHD treatment. However, moderate dose octreotide therapy resulted in prompt control of the bloody diarrhea, which rebounded on cessation of octreotide therapy. Rebound diarrhea responded promptly when the dose of octreotide was escalated. Octreotide was associated with an exacerbation of preexisting hypertension, but it appeared to be effective for control of severe, bloody diarrhea caused by acute GVHD in a child, with manageable side effects. Further studies of this application in infants and children are warranted.
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PMID:Continuous octreotide infusion for the treatment of secretory diarrhea caused by acute intestinal graft-versus-host disease in a child. 1095 6