Limited benefit of pentostatin salvage therapy for steroid-refractory grade III-IV acute graft-versus-host disease

被引:8
|
作者
Alam, Naheed [1 ]
Atenafu, Eshetu G. [2 ]
Tse, Garwin [3 ]
Viswabandya, Auro [1 ]
Gupta, Vikas [1 ]
Kim, Dennis [1 ]
Lipton, Jeffrey H. [1 ]
Messner, Hans A. [1 ]
Kuruvilla, John [1 ]
机构
[1] Univ Toronto, Princess Margaret Hosp, Allogene Blood & Marrow Transplant Program, Toronto, ON M5G 2M9, Canada
[2] Univ Toronto, Princess Margaret Hosp, Dept Biostat, Toronto, ON M5G 2M9, Canada
[3] Univ Toronto, Princess Margaret Hosp, Dept Pharm, Toronto, ON M5G 2M9, Canada
关键词
graft-versus-host disease; hematopoietic cell transplant; pentostatin; BONE-MARROW-TRANSPLANTATION; STEM-CELL TRANSPLANTATION; RISK-FACTORS; ACUTE GVHD; SINGLE-CENTER; ALEMTUZUMAB; RESISTANT; SURVIVAL; DONOR; LEUKEMIA;
D O I
10.1111/ctr.12268
中图分类号
R61 [外科手术学];
学科分类号
摘要
Corticosteroid-refractory (SR) acute graft-versus-host disease (aGVHD) remains a major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation. Multiple agents have been evaluated in this setting, but the benefit of pentostatin has not been described well. We report a single-center experience of pentostatin salvage therapy for SR aGVHD. Fifteen patients received pentostatin for SR aGVHD from March 2005 till March 2010 after failure to respond to methylprednisolone 2mg/kg/d for at least sevend. All patients had grade III-IV aGVHD prior to pentostatin therapy. Thirteen (87%), 10 (67%), and six (40%) patients had gastrointestinal (GI), skin, and liver involvement of aGVHD, respectively. Pentostatin was given at a median of 33d after steroid therapy initiation. The dose of pentostatin was 1.4mg/m(2) daily for threed, repeated every twowk. Eight (53%) patients also received additional therapies. Complete responses were noted in two patients (both in skin). However, one patient relapsed and did not respond to additional salvage treatment. Partial responses were seen in three patients. Fourteen died of GVHD-related causes. This study suggested that pentostatin is of limited benefit in the treatment for SR grade III-IV aGVHD.
引用
收藏
页码:930 / 937
页数:8
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