Basiliximab in the Treatment of Acute Graft-Versus-Host Disease after Allogeneic Stem Cell Transplantation

Objective: To explore the efficiency and side-effects of basiliximab in the treatment of steroid-refractory acute graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (Allo-HSCT). Patients and Methods: Basiliximab, a chimeric interleukin-2 receptor antagonist, was evaluated in twenty-eight patients with steroid-refractory acute graft-versus-host disease after Allo-HSCT. Patients were transplanted from a related (n=9) or unrelated (n=6) HLA- identical donor or haplo-identical donor(n=13) because of chronic myelogenous leukemia (chronic phase n=11, accelerate phase n=2), acute myeloid leukemia (n=8), high risk acute lymphocytic leukemia (n=6), high risk non-Hodgkin’s lymphoma (n=1). Basiliximab was given at a dose of 20mg on the day after steroid-refractory acute GVHD had developed, and was repeated on day 4 in all these cases. The efficiency and side-effects of basiliximab were observed at the same time. Basiliximab was repeated again 4 weeks later in some cases of having response. Result: None had infusion-associated or other side-effects after the treatment with basiliximab. Twenty-two of 28 patients (78.57%) responded to basiliximab, 15/28(53.57%) had a complete response (CR) of acute GVHD and 7/28 (25.00%) had a partial response (PR). Six of 28 patients (21.43%) did not respond. Chronic GVHD developed in 15/24 evaluable patients. Only 9/24 evaluable patients have no chronic GVHD and all had a complete response before. Conclusion: Basiliximab is safe and effective in the treatment of steroid-refractory acute graft-versus-host disease (GVHD) after allogeneic stem cell transplantation(Allo-SCT).