Use of belatacept as alternative graft vs host disease prophylaxis in pediatric allogeneic hematopoietic stem cell transplantation

Pediatr Transplant. 2021 Sep;25(6):e14041. doi: 10.1111/petr.14041. Epub 2021 May 20.

Abstract

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.

Keywords: GvHD; belatacept; graft versus host disease.

Publication types

  • Case Reports

MeSH terms

  • Abatacept / therapeutic use*
  • Adolescent
  • Anemia, Aplastic / therapy*
  • Female
  • Graft vs Host Disease / prevention & control*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Infant
  • Myelodysplastic Syndromes / therapy*

Substances

  • Immunosuppressive Agents
  • Abatacept