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      Steroid myopathy in patients with acute graft-versus-host disease treated with high-dose steroid therapy.

      Bone Marrow Transplantation
      Acute Disease, Adult, Aged, Female, Graft vs Host Disease, complications, drug therapy, Hematopoietic Stem Cell Transplantation, adverse effects, Humans, Leukemia, Myeloid, therapy, Male, Methylprednisolone, administration & dosage, toxicity, Middle Aged, Muscular Diseases, chemically induced, Myelodysplastic Syndromes, Retrospective Studies, Steroids

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          Abstract

          High-dose steroids are the first line of treatment for acute graft-versus-host disease (aGVHD). Steroid myopathy is a debilitating steroid-induced complication that significantly impairs a patient's performance status. To determine the frequency and severity of steroid myopathy and other steroid related complications in patients with acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS) who developed grade >or=2 aGVHD after allogeneic hematopoietic stem cell transplantation (HSCT), we performed a retrospective analysis. Patients were included in the analysis if they had a diagnosis of AML/MDS, underwent an allogeneic HSCT between January 1996 and December 2001 and developed grade >or=2 aGVHD that was treated with 2 mg/kg of methylprednisolone and survived at least 100 days post transplant. A total of 70 patients fulfilled our inclusion criteria. Steroid myopathy was identified in 29 (41%) patients. Steroid myopathy was generally of moderate severity with severe debilitating steroid myopathy seen in only 3% of patients. We concluded that steroid myopathy is a common complication of high-dose steroid therapy after allogeneic HSCT in AML/MDS. Interventions aimed at preventing and treating this complication are warranted and need to be explored in prospective clinical trials.

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