Brief ArticlesTargeting Integrin α4β7 in Steroid-Refractory Intestinal Graft-versus-Host Disease

- Integrin α4β7 is involved in T cell alloreactivity in acute graft-versus-host disease (GVHD) of the gut.
- Vedolizumab, a monoclonal antibody, targets the homing of T cells to the intestinal endothelium through inhibition of binding of integrin α4β7.
- Six patients were treated with vedolizumab for grade IV gut GVHD with clinical responses.
- The findings presented in this case series give hope for novel therapy of steroid-refractory intestinal GVHD.

Steroid refractory acute graft-versus-host-disease of the gut is a serious complication associated with high mortality after allogeneic stem cell transplantation. Treatment options are limited and not predictably effective. We describe the treatment of steroid-refractory acute graft-versus-host-disease with vedolizumab, an antibody directed against integrin α4β7, in 6 patients. All patients responded, and 4 of 6 patients are alive with a median follow-up of 10 months.