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Combination Therapy with Inolimomab and Etanercept for Severe Steroid-Refractory Acute Graft-versus-Host Disease.
- Source :
-
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2016 Jan; Vol. 22 (1), pp. 179-82. Date of Electronic Publication: 2015 Sep 18. - Publication Year :
- 2016
-
Abstract
- Steroid-refractory acute graft-versus-host disease (aGVHD) remains an important cause of morbidity and mortality after allogeneic stem cell transplantation (SCT). A protocol on the management of aGVHD was introduced in our center that incorporated a prospective study on combination therapy with inolimomab (anti-IL-2Rα) and etanercept (anti-tumor necrosis factor-α) for steroid-refractory aGVHD. We evaluated the efficacy and safety in 21 consecutively treated patients. The patients had developed refractory aGVHD after SCT (n = 16) or donor lymphocyte infusion (n = 5), and aGVHD was classified as severe in all patients, mostly due to gastrointestinal involvement stages 2 to 4. No drug-related side effects were observed apart from the infections expected to occur in these severely immunocompromised patients. Overall response at day 28 of second-line therapy was 48% (10/21), with 6 and 4 patients achieving a complete and partial response, respectively. Eventually, 19 patients died (90%), with early mortality (<6 months) predominantly resulting from refractory aGVHD and secondary infections and late mortality resulting from relapse of the underlying disease. With a median follow-up of 55 days, the estimated rates of 6-month and 2-year overall survival were dismal, 29% and 10%, respectively. In conclusion, the combination of inolimomab and etanercept for steroid-refractory aGVHD failed to improve the dismal prognosis of severe steroid-refractory aGVHD.<br /> (Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Acute Disease
Adult
Aged
Allografts
Disease-Free Survival
Drug Therapy, Combination methods
Female
Humans
Male
Middle Aged
Stem Cell Transplantation
Steroids administration & dosage
Survival Rate
Antibodies, Monoclonal administration & dosage
Drug Resistance drug effects
Etanercept administration & dosage
Graft vs Host Disease drug therapy
Graft vs Host Disease etiology
Graft vs Host Disease mortality
Hematologic Neoplasms mortality
Hematologic Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1523-6536
- Volume :
- 22
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 26386320
- Full Text :
- https://doi.org/10.1016/j.bbmt.2015.08.039