Combination Therapy with Inolimomab and Etanercept for Severe Steroid-Refractory Acute Graft-versus-Host Disease

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...

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Bibliographic Details
Published in:Biology of blood and marrow transplantation 2016, Vol.22 (1), p.179-182
Main Authors: van Groningen, Lenneke F.J, Liefferink, Aleida M, de Haan, Anton F.J, Schaap, Nicolaas P.M, Donnelly, J. Peter, Blijlevens, Nicole M.A, van der Velden, Walter J.F.M
Format: Article
Language:English
Subjects:
Acute Disease
Acute GVHD
Adult
Aged
Allogeneic stem cell transplantation
Allografts
Antibodies, Monoclonal - administration & dosage
Disease-Free Survival
Drug Resistance - drug effects
Drug Therapy, Combination - methods
Etanercept
Etanercept - administration & dosage
Female
Graft vs Host Disease - drug therapy
Graft vs Host Disease - etiology
Graft vs Host Disease - mortality
Hematologic Neoplasms - mortality
Hematologic Neoplasms - therapy
Hematology, Oncology and Palliative Medicine
Humans
Inolimomab
Male
Middle Aged
Stem Cell Transplantation
Steroid refractory
Steroids - administration & dosage
Survival Rate
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Summary: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 (
ISSN:1083-8791
1523-6536
DOI:10.1016/j.bbmt.2015.08.039