Factor XIII replacement in stem cell transplant (SCT) recipients with severe graft-versus-host disease of the bowel: Report of an initial experience

Background. Severe acute graft-versus-host disease (aGVHD) of the gut is a serious and frequent posttransplantation event associated with a high morta lity rate. We report on our experience with factor XIII replacement in pati ents with severe aGVHD of the bowel after allogeneic hematopoietic stem cel l transplantation. Methods. Twenty-seven patients after allogeneic stem cell transplantation a nd severe aGVHD of the gut were enrolled. All patients suffered from bloody diarrhea that required packed red blood cell infusions. All patients recei ved high-dose immunosuppression in combination with coagulation factor XIII (5,000 units initially, followed by 20 IU/kg body weight three times a day ) for up to 3 weeks. Results. After 8 days of factor XIII replacement and unchanged high-dose im munosuppression, we observed a significant reduction in the red blood cell requirement of 21 patients. Conclusion. We conclude that factor XIII replacement might be a useful supp lementation in the treatment of aGVHD of the bowel.