Tocilizumab as first-line therapy for steroid-refractory acute graft-versus-host-disease: analysis of a single-center experience.

Autor: Yucebay F; Department of Pharmacy, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , 43210 , USA., Matthews C; Department of Pharmacy, Roswell Park Comprehensive Cancer Center , Buffalo , New York , USA., Puto M; Department of Pharmacy, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , 43210 , USA., Li J; College of Pharmacy, Ohio State University , Columbus , Ohio , USA., William B; Division of Hematology, Department of Internal Medicine, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , USA., Jaglowski SM; Division of Hematology, Department of Internal Medicine, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , USA., Penza SL; Division of Hematology, Department of Internal Medicine, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , USA., Vasu S; Division of Hematology, Department of Internal Medicine, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , USA., Benson DM; Division of Hematology, Department of Internal Medicine, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , USA., Andritsos LA; Division of Hematology, Department of Internal Medicine, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , USA., Devine SM; Division of Hematology, Department of Internal Medicine, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , USA., Efebera YA; Division of Hematology, Department of Internal Medicine, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , USA., Roddy JVF; Department of Pharmacy, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center , Columbus , Ohio , 43210 , USA.
Jazyk: angličtina
Zdroj: Leukemia & lymphoma [Leuk Lymphoma] 2019 Sep; Vol. 60 (9), pp. 2223-2229. Date of Electronic Publication: 2019 Feb 15.
DOI: 10.1080/10428194.2019.1573996
Abstrakt: Acute graft-versus-host-disease (aGVHD) is a complication after allogeneic stem cell transplant. After the failure of treatment with high dose corticosteroids, steroid-refractory aGVHD (SR aGVHD) is associated with high rates of mortality. Tocilizumab has evidence of activity in SR aGVHD. For patients ineligible for trials, the OSU James Comprehensive Cancer Center has been utilizing tocilizumab as first-line therapy for SR aGVHD. We retrospectively report on 15 patients who received tocilizumab. aGVHD grading and responses were based on consensus criteria. Median age at transplant was 49 years. Median time to tocilizumab administration was 9 days (range, 3-16). Six patients had complete responses (40%) with a resolution of aGVHD. From the last contact, median overall survival for responders was not yet reached vs. 31 days for non-responders ( p  = .0002). Patients with skin and/or GI aGVHD demonstrated the greatest benefit. Patients with liver aGVHD did not respond. Future studies are needed to evaluate tocilizumab prior to steroid failure.
Databáze: MEDLINE
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