Treatment with gabexate mesilate for interstitial pneumonia after bone marrow transplantation.

The incidence of interstitial pneumonia (IP) after bone marrow transplantation (BMT) were decreased by; the fractionation of total body irradiation, anti-cytomegalovirus antibody negative platelet transfusion and prophylactic administration of anti-cytomegalovirus immunoglobulin. However, the establishment of much better prophylactic procedures and treatments for IP after BMT is essential when considering the mortality rate. On the other hand, it has been reported that superoxide and some protease released by neutrophils may be related to the progression of interstitial pneumonia.Gabexate mesilate (FOY), a protease inhibitor, was used in two cases which were clinically diagnosed to be IP after BMT. Effects of FOY were remarkable with the improvement of clinical findings and recovery from IP. The inhibitory effect of FOY on superoxide production by neutrophils in vivo and in vitro was examined. FOY did not suppress the production of superoxide by the neutrophils in vitro, but did suppress in vivo. These results suggest that FOY improved the clinical findings of patients with IP after BMT by the indirect suppression of the production superoxide by the neutrophils.