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International Journal of Hematology

, Volume 110, Issue 2, pp 260–262 | Cite as

Macrophage elimination in bone marrow by dexamethasone palmitate is associated with successful engraftment in patients with hemophagocytic syndrome

  • Hiroyuki Sugiura
  • Ken-ichi MatsuokaEmail author
  • Masayuki Matsuda
  • Shuntaro Ikegawa
  • Tomoko Inomata
  • Taiga Kuroi
  • Takeru Asano
  • Shohei Yoshida
  • Hisakazu Nishimori
  • Keiko Fujii
  • Nobuharu Fujii
  • Yoshinobu Maeda
Letter to the Editor
  • 90 Downloads

Nishiwaki et al. described a novel treatment using dexamethasone palmitate (DP) for hemophagocytic syndrome (HPS) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) [1]. Because HPS after allo-HSCT frequently progresses to graft failure (GF), aggressive treatments, including corticosteroids, cyclosporine, high-dose immune globulin, and etoposide, have been adopted. However, the efficacy of these conventional treatments for HPS remains unsatisfactory, and moreover, they can result in worsening neutropenia and immune insufficiency. DP is readily taken up by macrophages via phagocytosis and is retained in the cytoplasm. Therefore, DP may be more effective and less toxic for patients with HPS than conventional treatments. Based on Nishiwaki’s study [1], we conducted a retrospective analysis of DP treatment for 16 patients with post-transplant HPS and explored whether surrogate markers can predict the efficacy of DP at preventing GF in patients with HPS after allo-HSCT....

Keywords

Transplantation Hemophagocytic syndrome Dexamethasone palmitate 

Notes

Acknowledgements

We thank the staff of the hematopoietic stem cell transplantation team at Okayama University Hospital.

Author contributions

HS managed the clinical practice and wrote the paper. KM supervised the clinical practice and edited the paper. MM, SI, TI, TK, TA, and SY advised and edited the paper. HN, KF, NF, and YM supervised clinical practice.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. A summary of relevant information will be published with the manuscript.

Supplementary material

12185_2019_2659_MOESM1_ESM.docx (72 kb)
Supplementary material 1 (DOCX 72 kb)

References

  1. 1.
    Nishiwaki S, Nakayama T, Murata M, Nishida T, Sugimoto K, Saito S, et al. Dexamethasone palmitate successfully attenuates hemophagocytic syndrome after allogeneic stem cell transplantation: macrophage-targeted steroid therapy. Int J Hematol. 2012;95(4):428–33.CrossRefGoogle Scholar
  2. 2.
    Sakaguchi H, Matsumoto K, Yoshida N, Narita K, Hamada M, Kataoka S, et al. Dexamethasone palmitate for patients with engraftment syndrome is associated with favorable outcome for children with hematological malignancy. Bone Marrow Transpl. 2016;51(11):1540–2.CrossRefGoogle Scholar
  3. 3.
    Takagi S, Masuoka K, Uchida N, Ishiwata K, Araoka H, Tsuji M, et al. High incidence of haemophagocytic syndrome following umbilical cord blood transplantation for adults. Br J Haematol. 2009;147(4):543–53.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Hematology 2019

Authors and Affiliations

  • Hiroyuki Sugiura
    • 1
  • Ken-ichi Matsuoka
    • 1
    Email author
  • Masayuki Matsuda
    • 1
  • Shuntaro Ikegawa
    • 1
  • Tomoko Inomata
    • 1
  • Taiga Kuroi
    • 1
  • Takeru Asano
    • 1
  • Shohei Yoshida
    • 1
  • Hisakazu Nishimori
    • 1
  • Keiko Fujii
    • 1
  • Nobuharu Fujii
    • 1
  • Yoshinobu Maeda
    • 1
  1. 1.Department of Hematology and OncologyOkayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesOkayamaJapan

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