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.