Ruxolitinib in refractory acute and chronic graft-versus-host disease: a multicenter survey study
Por:
Gomez, VE, Garcia-Gutierrez, V, Corral, LL, Cadenas, IG, Martinez, AP, Malaver, FMJ, Caballero-Velazquez, T, Sierra, PGA, Alegria, MCV, Salinas, IPM, Cabrera, CC, Vicent, MG, Torres, NR, Porras, RP, Coll, CF, Orti, G, Ferreiras, DV, Llanza, RD, Moles, P, Velazquez-Kennedy, K, Mende, MJ, Barrigon, DC, Perez, E, Bofarull, RM, Gerosa, SS, Sierra, J, Poch, M, Ripa, MTZ, Perez, MDA, Angulo, BM, Ortega, IS, Caballer, JS, Gomez, JM, Tocino, IE, Perez-Simon, JA and GETH
Publicada:
1 mar 2020
Ahead of Print:
7 nov 2019
Resumen:
Graft-versus-host disease is the main cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. First-line treatment is based on the use of high doses of corticosteroids. Unfortunately, second-line treatment for both acute and chronic graft-versus-host disease, remains a challenge. Ruxolitinib has been shown as an effective and safe treatment option for these patients. Seventy-nine patients received ruxolitinib and were evaluated in this retrospective and multicenter study. Twenty-three patients received ruxolitinib for refractory acute graft-versus-host disease after a median of 3 (range 1-5) previous lines of therapy. Overall response rate was 69.5% (16/23) which was obtained after a median of 2 weeks of treatment, and 21.7% (5/23) reached complete remission. Fifty-six patients were evaluated for refractory chronic graft-versus-host disease. The median number of previous lines of therapy was 3 (range 1-10). Overall response rate was 57.1% (32/56) with 3.5% (2/56) obtaining complete remission after a median of 4 weeks. Tapering of corticosteroids was possible in both acute (17/23, 73%) and chronic graft-versus-host disease (32/56, 57.1%) groups. Overall survival was 47% (CI: 23-67%) at 6 months for patients with aGVHD (62 vs 28% in responders vs non-responders) and 81% (CI: 63-89%) at 1 year for patients with cGVHD (83 vs 76% in responders vs non-responders). Ruxolitinib in the real life setting is an effective and safe treatment option for GVHD, with an ORR of 69.5% and 57.1% for refractory acute and chronic graft-versus-host disease, respectively, in heavily pretreated patients.
Filiaciones:
Gomez, VE:
Univ Seville, Univ Hosp Virgen Rocio, Inst Biomed IBIS CSIC CIBERONC, Dept Hematol,CB16 12 00480, Seville, Spain
Garcia-Gutierrez, V:
Univ Hosp Ramon y Cajal, IRYCIS, Dept Hematol, Madrid, Spain
Corral, LL:
Complejo Asistencial Univ Salamanca IBSAL, Ctr Invest Canc IBMCC, Salamanca, Spain
Cadenas, IG:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Martinez, AP:
Clin Univ Hosp Valencia, Valencia, Spain
Malaver, FMJ:
Univ Seville, Univ Hosp Virgen Rocio, Inst Biomed IBIS CSIC CIBERONC, Dept Hematol,CB16 12 00480, Seville, Spain
Caballero-Velazquez, T:
Univ Seville, Univ Hosp Virgen Rocio, Inst Biomed IBIS CSIC CIBERONC, Dept Hematol,CB16 12 00480, Seville, Spain
Sierra, PGA:
Univ Hosp, Granada, Spain
Alegria, MCV:
Hosp Navarra, Navarra, Spain
Salinas, IPM:
Univ Hosp Miguel Servet, Zaragoza, Spain
Cabrera, CC:
Univ Seville, Univ Hosp Virgen Rocio, Inst Biomed IBIS CSIC CIBERONC, Dept Hematol,CB16 12 00480, Seville, Spain
Vicent, MG:
Hosp Nino Jesus, Madrid, Spain
Torres, NR:
Univ Seville, Univ Hosp Virgen Rocio, Inst Biomed IBIS CSIC CIBERONC, Dept Hematol,CB16 12 00480, Seville, Spain
Porras, RP:
Inst Catala Oncol Hospitalet, Barcelona, Spain
:
Inst Catala Oncol Germans Trias, Badalona, Spain
Orti, G:
Univ Hosp Vall dHebron, Barcelona, Spain
Ferreiras, DV:
Univ Hosp Vall dHebron, Barcelona, Spain
Llanza, RD:
Hosp La Princesa, Madrid, Spain
Moles, P:
Hosp La Fe, Valencia, Spain
Velazquez-Kennedy, K:
Univ Hosp Ramon y Cajal, IRYCIS, Dept Hematol, Madrid, Spain
Mende, MJ:
Complejo Asistencial Univ Salamanca IBSAL, Ctr Invest Canc IBMCC, Salamanca, Spain
Barrigon, DC:
Complejo Asistencial Univ Salamanca IBSAL, Ctr Invest Canc IBMCC, Salamanca, Spain
Perez, E:
Complejo Asistencial Univ Salamanca IBSAL, Ctr Invest Canc IBMCC, Salamanca, Spain
Bofarull, RM:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Gerosa, SS:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Sierra, J:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Poch, M:
Clin Univ Hosp Valencia, Valencia, Spain
Ripa, MTZ:
Hosp Navarra, Navarra, Spain
Perez, MDA:
Hosp Nino Jesus, Madrid, Spain
Angulo, BM:
Hosp Nino Jesus, Madrid, Spain
Ortega, IS:
Inst Catala Oncol Hospitalet, Barcelona, Spain
Caballer, JS:
Hosp La Fe, Valencia, Spain
Gomez, JM:
Hosp La Fe, Valencia, Spain
Tocino, IE:
Univ Seville, Univ Hosp Virgen Rocio, Inst Biomed IBIS CSIC CIBERONC, Dept Hematol,CB16 12 00480, Seville, Spain
Perez-Simon, JA:
Univ Seville, Univ Hosp Virgen Rocio, Inst Biomed IBIS CSIC CIBERONC, Dept Hematol,CB16 12 00480, Seville, Spain
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