Abstract |
Objective: To investigate the efficacy of anti-CD(25) monoclonal antibody for steroid-refractory acute graft-versus-host disease (SR-aGVHD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Methods: A total of 80 patients with SR-aGVHD from January 1st 2012 to December 31st 20l6 were enrolled in this study. Acute GVHD were classified as classic aGVHD (n=72) and late-onset aGVHD (n=8). Anti-CD(25) monoclonal antibodys (mAb) were administrated on days 1, 4, 8, 15, and 22. The efficacy of anti-CD(25) mAb was evaluated at day 28 after the initial treatment. The associated factors of clinical outcome were analyzed. Results: The overall response (OR) rate of anti-CD(25) mAb was 75% (60/80), with complete response (CR) rate, partial response (PR) rate and no response(NR) rate 52.5% (42/80), 22.5% (18/80), and 25% (20/80), respectively. GVHD-relapse was not observed with a median follow-up time of 394.5 days (range, 12-1 761 days). The 6-month overall survival (OS) rate was 68.4%(95%CI 63.2%-73.6%). The 1-year OS rate was 63.1% (95%CI 57.6%-68.6%), and 2-years OS rate was 50.7% (95%CI 44.3%-57.1%). Non-relapse mortality (NRM) rate of 1 and 3 years was 32.6% (95%CI 27.2%-38%) and 41.7% (95%CI 35.3%-48.1%), respectively. The 1 and 2 years cumulative incidence of chronic graft versus host disease (cGVHD) was 32.9% (95%CI 26.4%-39.4%) and 38.9% (95%CI 31.8%-46.0%). By univariate and multivariate analysis, liver involvement was an independent poor risk factor of SR-aGVHD (OR=4.66, 95%CI 1.145-18.962, P=0.032). Conclusion: Anti-CD(25) mAb serves as an alternative and effective salvage therapy for SR-aGVHD at present. Liver involvement is a predictive factor of poor response in patients with SR-aGVHD.
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Authors | T Tao, S L Xue, F Chen, Y Xu, X Ma, M Miao, X W Tang, D P Wu |
Journal | Zhonghua nei ke za zhi
(Zhonghua Nei Ke Za Zhi)
Vol. 57
Issue 5
Pg. 324-329
(May 01 2018)
ISSN: 0578-1426 [Print] China |
PMID | 29747286
(Publication Type: Journal Article)
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Chemical References |
- Antibodies, Monoclonal
- Steroids
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Topics |
- Antibodies, Monoclonal
(administration & dosage, therapeutic use)
- Graft vs Host Disease
(drug therapy)
- Hematopoietic Stem Cell Transplantation
(adverse effects, methods)
- Humans
- Incidence
- Recurrence
- Remission Induction
- Risk Factors
- Salvage Therapy
(methods)
- Steroids
(pharmacology)
- Survival Rate
- Treatment Outcome
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