Ruxolitinib is an effective salvage treatment for multidrug-resistant graft-versus-host disease after haploidentical allogeneic hematopoietic stem cell transplantation without posttransplant cyclophosphamide.
Jiao-Yu ZhaoSi-Ning LiuLan-Ping XuXiao-Hui ZhangYu WangYu-Hong ChenKai-Yan LiuXiao-Jun HuangXiao-Dong MoPublished in: Annals of hematology (2020)
The purpose of our study is to identify the efficacy of ruxolitinib in human leukocyte antigen (HLA) haploidentical hematopoietic stem cell transplantation (haplo-HSCT) recipients with multidrug-resistant (MDR)-graft-versus-host disease (GVHD, n = 34). MDR-GVHD was defined as GVHD showing no improvement after at least 3 types of treatments. The median number of previous GVHD-therapies was 4 for both MDR-acute GVHD (aGVHD) and MDR-chronic GVHD (cGVHD). For MDR-aGVHD (n = 15), the median time to response was 10 days (range 2 to 65), and the overall response rate (ORR) was 60.0% (9/15), including 40.0% (6/15) complete response (CR) and 20.0% (3/15) partial response (PR). The 1-year probability of overall survival after ruxolitinib was 66.7%. The rates of hematologic and infectious toxicities were 73.3% and 46.7% after ruxolitinib treatment. For MDR-cGVHD (n = 19), the median time to response was 29 days (range 6 to 175), and the ORR was 89.5% (17/19), including 26.3% (5/19) CR and 63.2% (12/19) PR. All patients remained alive until our last follow-up. The rates of hematologic and infectious toxicities were 36.8% and 47.4% after ruxolitinib treatment. Ruxolitinib is an effective salvage treatment for MDR-GVHD in haplo-HSCT recipients.
Keyphrases
- multidrug resistant
- allogeneic hematopoietic stem cell transplantation
- drug resistant
- acinetobacter baumannii
- gram negative
- acute myeloid leukemia
- acute lymphoblastic leukemia
- bone marrow
- klebsiella pneumoniae
- low dose
- stem cell transplantation
- newly diagnosed
- pseudomonas aeruginosa
- liver failure
- high dose
- respiratory failure
- kidney transplantation
- drug induced