Purpose:
Phase II efficacy evaluation, phase I/II efficacy and toxicity trial of recombinant human
keratinocyte growth factor for the treatment of steroid refractory gastrointestinal graft
versus host disease.
Study summary:
There are two processes that cause diarrhea as the clinical manifestation of graft versus
host disease. The first is the obvious immunologic attack on the colonic epithelium of the
recipient. Once this immunologic attack has been abated the recipient is left with a
colonic mucosa that is devoid of microvilli and has a smooth intestinal boarder. This is
frequently subject to superinfections from bacteria all of which cause the diarrhea to
continue. Researchers only endpoint to measure clinical response of immunosuppression is
the resolution of diarrhea. The human recombinant keratinocyte growth factor stimulates
the growth of colonic epithelium. The growth of colonic epithelium will in turn probably
ameliorate some of the diarrhea associated with graft versus host disease.
Criteria:
Inclusion criteria:
- Patients post allogeneic bone marrow transplant with watery diarrhea progressed on
2mg/kg of steroids after 3 days or failed to improve after 5 days.
- Patients may have skin or liver involvement with graft versus host disease.
- Patients should not have any infections etiology for diarrhea.
Exclusion criteria:
- None