International Journal of Hematology

, Volume 80, Issue 5, pp 463–466 | Cite as

Experience with the Use of Salazosulfapyridine for Intractable Diarrhea after Hematopoietic Stem Cell Transplantation

  • Naohiko Moriguchi
  • Sadayuki Isokawa
  • Atsushi Ando
  • Hiroshi Miyata
Case Report
  • 55 Downloads

Abstract

We encountered 2 children with intractable diarrhea after allogeneic hematopoietic stem cell transplantation (SCT). In both cases, salazosulfapyridine (SASP) was administered to treat the diarrhea. One patient was a 14-year-old male with acute mye-logenous leukemia who received SCT from a related HLA-identical donor. The leukemia recurred early, and a second SCT from the same donor was performed approximately half a year later. Because intestinal graft-versus-host disease (GVHD) was observed, steroids and octreotide were administered, but the symptoms were not improved. Thereafter, SASP was administered, and the symptoms remitted 9 days later. The other patient was a 12-year-old male with chronic myelogenous leukemia who received SCT from an unrelated HLA-identical donor. Diarrhea and abdominal pain developed early after engraftment and did not respond to either steroids or tacrolimus. Oral administration of SASP was initiated on day 236, and the diarrhea remitted 4 days later without recurrence thereafter. SASP may be effective in children for the digestive system symptoms of chronic GVHD.

Key words

Stem cell transplantation Diarrhea Graft-versus-host disease Salazosulfapyridine 

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References

  1. 1.
    Cox GJ, Matsui SM, Lo RS, et al. Etiology and outcome of diarrhea after marrow transplantation: a prospective study. Gastroenterology. 1994;107:1398–1407.CrossRefPubMedGoogle Scholar
  2. 2.
    Gaginellia TS, Walsh RE. Sulfasalazine: multiplicity of action. Dig Dis Sci. 1992;37:801–812.CrossRefGoogle Scholar
  3. 3.
    Murray KJ. Advanced therapy for juvenile arthritis. Best Pract Res Clin Rheumatol. 2002;16:361–378.CrossRefPubMedGoogle Scholar
  4. 4.
    Crouch MA, Restino MS, Cruz JM, Perry JJ, Hurd DD. Octreotide acetate in refractory bone marrow transplant-associated diarrhea. Ann Pharmacother. 1996;30:331–336.CrossRefPubMedGoogle Scholar
  5. 5.
    Okada M, Okamoto, Yamada S, et al. Successful treatment of chronic graft-versus-host disease with sulfasalazine in allogeneic bone marrow transplantation. Acta Haematol. 1999;102:107–109.CrossRefPubMedGoogle Scholar
  6. 6.
    Ireland A, Jewell DP. Mechanism of action of 5-aminosalicylic acid and its derivatives. Clin Sci. 1990;78:119–125.CrossRefPubMedGoogle Scholar
  7. 7.
    Mahida YR, Lamming CE, Gallagher A, Hawthorne AB, Hawkey CJ. 5-Aminosalicylic acid is a potent inhibitor of interleukin lß production in organ culture of colonic biopsy specimens from patients with inflammatory bowel disease. Gut. 1991;32:50–54.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Kaiser GC, Yan F, Polk B. Mesalamine blocks tumor necrosis factor growth inhibition and nuclear factor kB activation in mouse colonocytes. Gastroenterology. 1999;116:602–609.CrossRefPubMedGoogle Scholar
  9. 9.
    Wanders A, Tufveson G, Gerdin B. Enhancement of the effect of low-dose cyclosporin A by sulphasalazine in prevention of cardiac allograft rejection in the rat. Transpl Int. 1992;5:155–158.PubMedGoogle Scholar
  10. 10.
    Laasila K, Leirisalo-Repo M. Side effect of sulphasalazine in patients with rheumatic disease or inflammatory bowel disease. Scand J Rheumatol. 1994;23:338–340.CrossRefPubMedGoogle Scholar
  11. 11.
    Baker DE, Kane S. The short- and long-term safety of 5-aminosalicylate products in the treatment of ulcerative colitis. Rev Gastroenterol Disord. 2004;4:86–91.PubMedGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2004

Authors and Affiliations

  • Naohiko Moriguchi
    • 1
  • Sadayuki Isokawa
    • 2
  • Atsushi Ando
    • 1
  • Hiroshi Miyata
    • 1
  1. 1.Department of PediatricsSakai Hospital, Kinki University School of MedicineSakai
  2. 2.Department of PediatricsKinki University School of MedicineOsakaJapan

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