51. Pentostatin therapy for steroid-refractory acute graft versus host disease: identifying those who may benefit
- Author
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Ragon, Brittany Knick, Mehta, Rohtesh S, Gulbis, Alison M, Saliba, Rima M, Chen, Julianne, Rondon, Gabriela, Popat, Uday R, Nieto, Yago, Oran, Betul, Olson, Amanda L, Patel, Krina, Hosing, Chitra M, Qazilbash, Muzaffar H, Shah, Nina, Kebriaei, Partow, Shpall, Elizabeth J, Champlin, Richard E, and Alousi, Amin M
- Subjects
Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Rare Diseases ,Transplantation ,Clinical Research ,Cancer ,Oral and gastrointestinal ,Good Health and Well Being ,Acute Disease ,Adolescent ,Adult ,Age Factors ,Aged ,Child ,Child ,Preschool ,Female ,Gastrointestinal Diseases ,Graft vs Host Disease ,Humans ,Liver Diseases ,Male ,Middle Aged ,Patient Selection ,Pentostatin ,Prognosis ,Risk Factors ,Salvage Therapy ,Steroids ,Survival Analysis ,Young Adult ,Clinical Sciences ,Oncology and Carcinogenesis ,Immunology ,Cardiovascular medicine and haematology ,Oncology and carcinogenesis - Abstract
We report outcomes of 60 patients with steroid-refractory (SR)-aGVHD treated with pentostatin. Almost half (47%) of patients had grade 4 GVHD-22% had stage 3-4 liver GVHD and 51% had stage 3-4 lower gastrointestinal tract (LGI) GVHD. Patients received a median of 3 courses (range, 1-9) of pentostatin. Day 28 overall response rate (ORR) was 33% (n = 20) (complete response 18% (n = 11), partial response 15% (n = 9)). Non-relapse mortality was 72% (95% confidence interval (CI) 61-84%) and overall survival (OS) was 21% (95% CI 12-32%) at 18 months. On univariate analysis, age >60 years (HR 1.9, 95% CI 1.01-3.7, p = 0.045) and presence of liver GVHD (HR 1.9, 95% CI 1.9, 95% CI 1.5-3.3, p = 0.03) were significant predictors of poor OS while patients with LGI GVHD had superior OS than those without (HR 0.4, 95% CI 0.2-0.8, p = 0.01). On stratified analysis, patients
- Published
- 2018