Related Experiment Video
Updated: Jul 16, 2026
Bone Marrow Transplantation Platform to Investigate the Role of Dendritic Cells in Graft-versus-Host Disease
Published on: March 17, 2020
Sparing effect by montelukast treatment for chronic graft versus host disease: a pilot study
Reuven Or1, Benjamin Gesundheit, Igor Resnick
1Department of Bone Marrow Transplantation, Cancer Immunotherapy & Immunobiology Research Center, Hadassah Hebrew University Medical Center, Jerusalem, Israel. reuvenor@hadassah.org.il
Insights
Montelukast (Mk) shows promise in treating chronic graft-versus-host disease (GvHD) after stem cell transplantation. This safe, supplementary therapy improved symptoms in 79% of patients, offering a potential toxicity-sparing option for GvHD management.
Area of Science:
- Hematology
- Immunology
- Pharmacology
Background:
- Chronic graft-versus-host disease (GvHD) is a significant complication following allogeneic stem cell transplantation (SCT).
- It is a leading cause of morbidity and mortality in long-term SCT survivors.
- Cysteinyl leukotrienes (cysLTs) and eosinophils are implicated in GvHD pathogenesis.
Purpose of the Study:
- To evaluate the efficacy and safety of montelukast (Mk) as an add-on therapy for chronic GvHD.
- To assess the impact of Mk on organ-specific manifestations of GvHD.
Main Methods:
- A prospective study involving 19 patients with refractory chronic GvHD.
- Patients received oral montelukast (10 mg daily) in addition to standard immunosuppression for a mean of 10 months.
- Organ-specific responses were assessed using NIH consensus criteria.
Main Results:
- An overall response rate of 79% (15/19 patients) was observed with combined therapy.
- Significant improvements were noted in skin (53%), liver (62%), and gastrointestinal (46%) GvHD.
- Montelukast was beneficial in milder GvHD stages, allowing earlier reduction of other immunosuppressants.
- No side effects or disease relapses were documented.
Conclusions:
- Montelukast (Mk) appears to be a safe and effective supplementary treatment for chronic GvHD.
- This preliminary study supports Mk's potential to spare toxicity associated with standard GvHD therapies.
- Further clinical trials are needed to determine optimal dosing and its role in acute and chronic GvHD prophylaxis and treatment.
Background:
Chronic graft versus host disease (GvHD) is a major complication after allogeneic stem cell transplantation (SCT), which is usually progression from acute GvHD. Chronic GvHD is the main cause of severe morbidity and mortality in long-term survivors after SCT. The cysteinyl leukotrienes (cysLTs) and eosinophils play an important role in the pathogenesis of GvHD, which is the rationale for the combined use of montelukast (Mk) in the treatment of this illness.
Methods:
Mk was administrated to 19 eligible patients with refractory chronic GvHD, in addition to their standard immunosuppressive regimens. Mk was given orally (10 mg once daily) for a mean period of 10 months (range, 2-21 months). Organ-specific response was determined by the new scoring criteria established by the National Institutes of Health consensus project.
Results:
Based on organ involvements endpoints, overall response to the combined therapy with Mk was observed in 15 of 19 (79%) patients. Significant improvement of skin liver and gastrointestinal was observed in 53%, 62%, and 46%, respectively. Generally, Mk was notably beneficial in milder stages of GvHD, which lead to earlier withdrawal of other immunosuppressive agents. Side effects of Mk administration were not documented, nor were cases of relapse of the basic disease.
Conclusions:
Our preliminary prospective investigation supports the potential efficacy of Mk as a safe and toxicity-sparing supplement to standard therapy for patients with chronic GvHD. Future clinical studies are necessary to establish the optimal dose of Mk and its role in the symptomatic and prophylactic treatment of acute and chronic GvHD.
Related Concept Videos
01:19Antiasthma Drugs: Leukotriene Modifiers
Leukotriene modifiers work through two distinct mechanisms:
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.