| Autor: |
Delphine Lebon, Adèle Dujardin, Alexis Caulier, Magalie Joris, Amandine Charbonnier, Bérengère Gruson, Marine Quint, Sandrine Castelain, Catherine François, Marie-Noëlle Lacassagne, Nicolas Guillaume, Jean-Pierre Marolleau, Pierre Morel |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Leukemia Research. 125:107005 |
| ISSN: |
0145-2126 |
| DOI: |
10.1016/j.leukres.2022.107005 |
| Popis: |
Steroid-refractory graft-versus-host disease (SR-GVHD) is a challenging complication of allogeneic hematopoietic stem cell transplantation, and leads to high morbidity and mortality rates. The orally administered, selective Janus-associated kinase 1/2 inhibitor ruxolitinib gives overall response rates (ORR) of more than 70 % in acute and chronic SR-GVHD. However, several studies have highlighted an elevated risk of cytomegalovirus (CMV) reactivation in patients with ruxolitinib-treated SR-GVHD.We therefore analyzed risk of CMV and Epstein-Barr virus (EBV) primary infection or reactivation in 57 patients with ruxolitinib-treated GVHD, while taking account of the competing risk (CR) of death prior to the first reactivation.Initiation of ruxolitinib treatment was a significant adverse prognostic factor for the CR of first CMV reactivation (hazard ratio (HR)= 1.747, 95 % confidence interval (CI): 1.33-2.92, p 0.0001) and first EBV reactivation (HR=2.657, 95 % CI: 1.82-3.87, p 0.0001) during GVHD. In our cohort of ruxolitinib-treated patients, the ORR (48 % and 58 % for acute and chronic GVHD, respectively) and the toxicity profile (haematological adverse events in 29.8 % of the patients) were similar to the literature values.Given ruxolitinib's efficacy in SR-GVHD, use of this drug should not be limited by the fear of viral reactivation; however, our present results emphasize the importance of monitoring the viral load. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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Full Text from ScienceDirect