201. Ruxolitinib–ECP combination treatment for refractory severe chronic graft-versus-host disease
- Author
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Robert Zeiser, Gabriele Ihorst, Kristina Maas-Bauer, Petya Apostolova, Jürgen Finke, Ralph Wäsch, Hartmut Bertz, and Chrissoula Kiote-Schmidt
- Subjects
Transplantation ,medicine.medical_specialty ,Cytopenia ,Ruxolitinib ,business.industry ,Salvage therapy ,Hematology ,Disease ,medicine.disease ,Gastroenterology ,Graft-versus-host disease ,Refractory ,hemic and lymphatic diseases ,Internal medicine ,Extracorporeal Photopheresis ,medicine ,business ,medicine.drug - Abstract
Glucocorticoid-refractory (SR) chronic (c) graft-versus-host disease (GVHD) is a multisystem immunological disease and the leading cause of non-relapse mortality (NRM) in patients surviving longer than 2 years after allogeneic hematopoietic cell transplantation. Both ruxolitinib (RUX) and extracorporeal photopheresis (ECP) have shown activity for SR-cGVHD which motivated us to treat refractory cGHVD patients with the RUX-ECP combination. In this retrospective survey, 23 patients received RUX-ECP as salvage therapy for SR-cGVHD. The best response (CR or PR) at any time point during treatment was 74% (17/23) including 9% (2/23) CR and 65% (15/23) PR. The 24-months-survival was 75% (CI 56.0-94.1). Newly diagnosed cytopenia occurred in 22% (5/23) and CMV reactivation was observed in 26% (6/23) of the patients. Serum levels of soluble interleukin-2 receptor (sIL-2R) correlated with response. Our retrospective analysis shows that the RUX-ECP combination is safe and has activity in a fraction of patients with SR-cGVHD, which needs validation in a prospective trial.
- Published
- 2020