Abdel-Kader Martín, LailaRodríguez Ochoa, Leonor2023-04-042023-04-042022Rodríguez Ochoa, L. (2022). Alternativas terapéuticas en el paciente trasplantado con enfermedad de injerto contra el huésped refractario a corticoides. (Trabajo Fin de Grado Inédito). Universidad de Sevilla, Sevilla.https://hdl.handle.net/11441/143940Graft-versus-host disease (GVHD) is the second most frequent cause of death after disease progression in bone marrow transplant patients. If the donor is a recipient’s relative, the probability of developing GVHD is 35% to 45%, while if the donor is not a relative, the probability increases to 60%-80%. The first line for the treatment of acute GVHD are steroids. However, between 35% and 50% develop steroid-refractory GVHD. The aim of this review is the evaluation of the efficacy and safety of therapeutic alternatives in patients who have developed steroid-refractory GVHD. A systematic review is carried out through an exhaustive search of the literature, following the PICO methodology. A total of 206 results are obtained. Finally, 12 fulfill the inclusion criteria. The overall response rate (ORR) (on day 28) was 38,2% and 12 months overall survival (OS) was 38% with brentuximab vedotin. From the studies with etanercept the ORR obtained was 53% and 87,5% and the OS was 61,2%. The studies with tocilizumab presented an ORR of 67% and 44% and the OS was 50% in both studies. The therapy with basiliximab obtained an ORR of 78,7% and an OS of 61,7%. The treatment with alemtuzumab the ORR observed was 55% and 70%, the OS was 0% and 50%. The studies with vedolizumab the ORR were 64%, 35%, 35,3% and 79% and the OS were 47%, 30%, 29,4% and 27,5%. All the studies presented the following complications but in different proportions: hematological, bacterial, viral and fungal infections and CMV reactivations. More scientific evidence is needed to prove the efficacy and safety of the drugs studied.application/pdf41 p.spaAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Acute GVHDSteroid-refractoryBone marrow transplantationEfficacySafetyinfo:eu-repo/semantics/bachelorThesisinfo:eu-repo/semantics/openAccess