Ruxolitinib in refractory acute and chronic graft-versus-host disease: a multicenter survey study

被引:61
作者
Gomez, Virginia Esamilla [1 ]
Garcia-Gutierrez, Valentin [2 ]
Corral, Lucia Lopez [3 ]
Cadenas, Irene Garcia [4 ]
Martinez, Ariadna Perez [5 ]
Malaver, Francisco J. Marquez [1 ]
Caballero-Velazquez, Teresa [1 ]
Sierra, Pedro A. Gonzalez [6 ]
Alegria, Maria C. Viguria [7 ]
Salinas, Ingrid M. Parra [8 ]
Cabrera, Cristina Calderon [1 ]
Vicent, Marta Gonzalez [9 ]
Torres, Nancy Rodriguez [1 ]
Porras, Rocio Parody [10 ]
Coll, Christelle Ferra [11 ]
Orti, Guillermo [12 ]
Ferreiras, David Valcarcel [12 ]
Llanza, Rafael De la Camara [13 ]
Moles, Paula [14 ]
Velazquez-Kennedy, Kyra [2 ]
Mende, Maria Joao [3 ]
Barrigon, Dolores Caballero [3 ]
Perez, Estefania [3 ]
Bofarull, Rodrigo Martino [4 ]
Gerosa, Silvanna Saavedra [4 ]
Sierra, Jorge [4 ]
Poch, Marc [5 ]
Ripa, Maria T. Zudaire [7 ]
Perez, Miguel A. Diaz [9 ]
Angulo, Blanca Molina [9 ]
Ortega, Isabel Sanchez [10 ]
Caballer, Jaime Sanz [14 ]
Gomez, Juan Montoro [14 ]
Tocino, Ildefonso Espigado [1 ]
Perez-Simon, Jose A. [1 ]
机构
[1] Univ Seville, Univ Hosp Virgen Rocio, Inst Biomed IBIS CSIC CIBERONC, Dept Hematol,CB16 12 00480, Seville, Spain
[2] Univ Hosp Ramon y Cajal, IRYCIS, Dept Hematol, Madrid, Spain
[3] Complejo Asistencial Univ Salamanca IBSAL, Ctr Invest Canc IBMCC, Salamanca, Spain
[4] Hosp Santa Creu & Sant Pau, Barcelona, Spain
[5] Clin Univ Hosp Valencia, Valencia, Spain
[6] Univ Hosp, Granada, Spain
[7] Hosp Navarra, Navarra, Spain
[8] Univ Hosp Miguel Servet, Zaragoza, Spain
[9] Hosp Nino Jesus, Madrid, Spain
[10] Inst Catala Oncol Hospitalet, Barcelona, Spain
[11] Inst Catala Oncol Germans Trias, Badalona, Spain
[12] Univ Hosp Vall dHebron, Barcelona, Spain
[13] Hosp La Princesa, Madrid, Spain
[14] Hosp La Fe, Valencia, Spain
关键词
CONSENSUS DEVELOPMENT PROJECT; AVAILABLE THERAPY; CLINICAL-TRIALS; RAPAMYCIN; IBRUTINIB; RESISTANT; CRITERIA;
D O I
10.1038/s41409-019-0731-x
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Graft-versus-host disease is the main cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. First-line treatment is based on the use of high doses of corticosteroids. Unfortunately, second-line treatment for both acute and chronic graft-versus-host disease, remains a challenge. Ruxolitinib has been shown as an effective and safe treatment option for these patients. Seventy-nine patients received ruxolitinib and were evaluated in this retrospective and multicenter study. Twenty-three patients received ruxolitinib for refractory acute graft-versus-host disease after a median of 3 (range 1-5) previous lines of therapy. Overall response rate was 69.5% (16/23) which was obtained after a median of 2 weeks of treatment, and 21.7% (5/23) reached complete remission. Fifty-six patients were evaluated for refractory chronic graft-versus-host disease. The median number of previous lines of therapy was 3 (range 1-10). Overall response rate was 57.1% (32/56) with 3.5% (2/56) obtaining complete remission after a median of 4 weeks. Tapering of corticosteroids was possible in both acute (17/23, 73%) and chronic graft-versus-host disease (32/56, 57.1%) groups. Overall survival was 47% (CI: 23-67%) at 6 months for patients with aGVHD (62 vs 28% in responders vs non-responders) and 81% (CI: 63-89%) at 1 year for patients with cGVHD (83 vs 76% in responders vs non-responders). Ruxolitinib in the real life setting is an effective and safe treatment option for GVHD, with an ORR of 69.5% and 57.1% for refractory acute and chronic graft-versus-host disease, respectively, in heavily pretreated patients.
引用
收藏
页码:641 / 648
页数:8
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