Kanojia M D, Anagnostou A A, Zander A R, Vellekoop L, Spitzer G, Verma D S, Jagannath S, Dicke K A
Transplantation. 1984 Mar;37(3):246-9. doi: 10.1097/00007890-198403000-00005.
High-dose methylprednisolone (HDMP) was used to treat 18 episodes of severe (grades III and IV) acute graft-versus-host disease (GVHD) that developed after allogeneic bone marrow transplantation in 12 patients with acute leukemia and in 2 with aplastic anemia. Most of the patients showed rapid improvement in GVHD, with complete resolution of the skin and gut manifestations. However, the response of liver disease to the treatment was slow and incomplete. Complications seen were interstitial pneumonia and fungal and viral infections. Seven patients survived for more than two months following the treatment of acute GVHD. Five of these became long-term survivors with a median survival of 22+ months (range 11-38 months); all five long-term survivors developed chronic GVHD and are alive at the time of this report. It appears that HDMP is an effective treatment for severe acute GVHD. However, its true efficacy can only be ascertained in a randomized study comparing high-dose and conventional-dose methylprednisolone.
大剂量甲基泼尼松龙（HDMP）用于治疗12例急性白血病患者和2例再生障碍性贫血患者在异基因骨髓移植后发生的18次严重（III级和IV级）急性移植物抗宿主病（GVHD）。大多数患者的GVHD迅速改善，皮肤和肠道表现完全消退。然而，肝病对治疗的反应缓慢且不完全。观察到的并发症有间质性肺炎以及真菌和病毒感染。7例患者在急性GVHD治疗后存活超过两个月。其中5例成为长期存活者，中位生存期为22 +个月（范围11 - 38个月）；所有5例长期存活者均发生慢性GVHD，在本报告撰写时仍存活。看来HDMP是治疗严重急性GVHD的有效方法。然而，其真正疗效只能在比较大剂量和常规剂量甲基泼尼松龙的随机研究中确定。
