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Ruxolitinib in corticosteroid-refractory graft-versus-host disease after allogeneic stem cell transplantation: a multicenter survey.
- Source :
- Leukemia (08876924); Oct2015, Vol. 29 Issue 10, p2062-2068, 7p, 1 Color Photograph, 2 Charts, 4 Graphs
- Publication Year :
- 2015
-
Abstract
- Despite major improvements in allogeneic hematopoietic cell transplantation over the past decades, corticosteroid-refractory (SR) acute (a) and chronic (c) graft-versus-host disease (GVHD) cause high mortality. Preclinical evidence indicates the potent anti-inflammatory properties of the JAK1/2 inhibitor ruxolitinib. In this retrospective survey, 19 stem cell transplant centers in Europe and the United States reported outcome data from 95 patients who had received ruxolitinib as salvage therapy for SR-GVHD. Patients were classified as having SR-aGVHD (n=54, all grades III or IV) or SR-cGVHD (n=41, all moderate or severe). The median number of previous GVHD-therapies was 3 for both SR-aGVHD (1-7) and SR-cGVHD (1-10). The overall response rate was 81.5% (44/54) in SR-aGVHD including 25 complete responses (46.3%), while for SR-cGVHD the ORR was 85.4% (35/41). Of those patients responding to ruxolitinib, the rate of GVHD-relapse was 6.8% (3/44) and 5.7% (2/35) for SR-aGVHD and SR-cGVHD, respectively. The 6-month-survival was 79% (67.3-90.7%, 95% confidence interval (CI)) and 97.4% (92.3-100%, 95% CI) for SR-aGVHD and SR-cGVHD, respectively. Cytopenia and cytomegalovirus-reactivation were observed during ruxolitinib treatment in both SR-aGVHD (30/54, 55.6% and 18/54, 33.3%) and SR-cGVHD (7/41, 17.1% and 6/41, 14.6%) patients. Ruxolitinib may constitute a promising new treatment option for SR-aGVHD and SR-cGVHD that should be validated in a prospective trial. [ABSTRACT FROM AUTHOR]
- Subjects :
- HETEROCYCLIC compounds
CORTICOSTEROIDS
BIOLOGICAL models
CLINICAL trials
COMPARATIVE studies
DRUG resistance in cancer cells
GRAFT versus host disease
HEMATOPOIETIC stem cell transplantation
HOMOGRAFTS
LONGITUDINAL method
RESEARCH methodology
MEDICAL cooperation
MICE
PROGNOSIS
RESEARCH
RESEARCH funding
SURVIVAL
TUMOR classification
DISEASE relapse
EVALUATION research
RETROSPECTIVE studies
SALVAGE therapy
HEMATOLOGIC malignancies
JANUS kinases
DISEASE complications
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 08876924
- Volume :
- 29
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- Leukemia (08876924)
- Publication Type :
- Academic Journal
- Accession number :
- 110162704
- Full Text :
- https://doi.org/10.1038/leu.2015.212