Cyclophosphamide for salvage therapy of chronic graft-versus-host disease: a retrospective analysis
| Autor: | Tobias Wertheimer, Tobias Bergler, Daniela Weber, Barbara Holler, Daniel Wolff, Wolfgang Herr, Klemens Angstwurm, Ernst Holler, Matthias Edinger, Matthias Fante |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Cyclophosphamide medicine.medical_treatment 610 Medizin Salvage therapy Graft vs Host Disease Malignancy Gastroenterology Cohort Studies Internal medicine medicine Humans Transplantation Homologous Aged Retrospective Studies Salvage Therapy ddc:610 Hematology business.industry Hematopoietic Stem Cell Transplantation Immunosuppression General Medicine Chronic graft versus host disease Middle Aged medicine.disease Vasculitis-like cGvHD manifestation Clinical trial Graft-versus-host disease Chronic graft versus host disease . Vasculitis-like cGvHD manifestation . Salvage therapy . Cyclophosphamide Chronic Disease Female Original Article business Nephritis Immunosuppressive Agents medicine.drug Follow-Up Studies |
| Zdroj: | Annals of Hematology |
| ISSN: | 1432-0584 |
| Popis: | We retrospectively analyzed the safety and efficacy of cyclophosphamide (cyclo) for salvage treatment of chronic graft-versus-host disease (cGvHD) and cGvHD-associated (glomerulo-)nephritis at our center between 01/2010 and 11/2019. We identified 13 patients (pts) receiving cyclo for treatment of moderate (3/13) and severe (6/13) steroid-refractory cGvHD, cGvHD-associated (glomerulo-)nephritis (3/13), or vasculitis-like CNS manifestation of cGvHD (1/13). Cyclo was started on median day 509 (range 42–8193) after cGvHD onset; the median duration of application was 153 days (range 14–486) with 2/13 currently continuing treatment. The National Institute of Health organ grading and the intensity of immunosuppression (IS) were assessed at cyclo start and repeated after 3, 6, and 12 months. Response assessment was stopped at the start of any additional new IS. The median time of follow up was 407 days (range 86–1534). Best response was 1/13 CR, 6/13 PR, 4/13 SD, 1/13 MR, and 1/13 PD (ORR 54%). Significant and durable response was observed especially in cGvHD-associated (glomerulo-)nephritis (3/3). Infectious complications > CTCAE grade III were observed in 3/12 pts. During cyclo therapy, none of the pts suffered from recurrence of underlying malignancy. Overall, cyclo was relatively well tolerated and showed responses in heavily pretreated patients but requires further evaluation within clinical trials. |
| Databáze: | OpenAIRE |
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