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

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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. Liposome-incorporated 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 first-line treatment for patients with HPS after allo-SCT.

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Acknowledgments

This study was supported in part by a grant from the Japan Society for the Promotion of Science to S.N., and in part by a Japanese Grant-in-Aid for Scientific Research [(C) 20591118] to T. Nakayama.

Conflict of interest

The authors declare conflict of interest.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Satoshi Nishiwaki, Takayuki Nakayama, Makoto Murata, Tetsuya Nishida, Kyoko Sugimoto, Shigeki Saito, Tomonori Kato, Hiroki Mizuno, Nobuhiko Imahashi & Tomoki Naoe

  2. Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan

    Satoshi Nishiwaki

  3. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Satoshi Nishiwaki, Nobuhiko Imahashi, Aika Seto, Yukiyasu Ozawa, Tatsunori Goto, Daisuke Koyama, Emi Yokohata, Naomi Kubota, Sonoko Kamoshita & Koichi Miyamura

  4. Department of Pediatrics, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Kimikazu Matsumoto

  5. Department of Pathology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Masafumi Ito

Authors
  1. Satoshi Nishiwaki
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  2. Takayuki Nakayama
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  3. Makoto Murata
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  4. Tetsuya Nishida
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  5. Kyoko Sugimoto
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  6. Shigeki Saito
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  7. Tomonori Kato
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  8. Hiroki Mizuno
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  9. Nobuhiko Imahashi
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  10. Aika Seto
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  11. Yukiyasu Ozawa
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  12. Tatsunori Goto
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  13. Daisuke Koyama
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  14. Emi Yokohata
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  15. Naomi Kubota
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  16. Sonoko Kamoshita
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  17. Koichi Miyamura
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  18. Kimikazu Matsumoto
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  19. Masafumi Ito
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  20. Tomoki Naoe
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Corresponding authors

Correspondence to Satoshi Nishiwaki or Takayuki Nakayama.

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Nishiwaki, S., Nakayama, T., Murata, M. et al. Dexamethasone palmitate successfully attenuates hemophagocytic syndrome after allogeneic stem cell transplantation: macrophage-targeted steroid therapy. Int J Hematol 95, 428–433 (2012). https://doi.org/10.1007/s12185-012-1023-z

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  • DOI: https://doi.org/10.1007/s12185-012-1023-z

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