Improved survival after LTx-associated acute GVHD with mAb therapy targeting IL2RAb and soluble TNFAb: Single-center experience and systematic review

Autor: Wim Laleman, Diethard Monbaliu, Chris Verslype, S. van der Merwe, Peter Vandenberghe, Jacques Pirenne, David Cassiman, M. Sainz Barriga, Steffen Fieuws, Raymond Aerts, Patrick Ferdinande, Yves Debaveye, R. C. Minnee, Ina Jochmans, Johan Maertens, Frederik Nevens
Rok vydání: 2018
Předmět:
Graft Rejection
Male
Graft vs Host Disease
Disease
030230 surgery
Single Center
Gastroenterology
Postoperative Complications
0302 clinical medicine
Risk Factors
Immunology and Allergy
Medicine
Pharmacology (medical)
Fisher's exact test
graft-versus-host disease (GVHD)
education.field_of_study
biology
Mortality rate
Graft Survival
Antibodies
Monoclonal
Middle Aged
Prognosis
Survival Rate
symbols
Female
030211 gastroenterology & hepatology
Antibody
Adult
medicine.medical_specialty
medicine.drug_class
Population
complication
clinical research/practice
Monoclonal antibody
03 medical and health sciences
symbols.namesake
Internal medicine
Humans
education
Aged
Retrospective Studies
Transplantation
Tumor Necrosis Factor-alpha
business.industry
Interleukin-2 Receptor alpha Subunit
Liver Transplantation
biology.protein
business
Complication
liver transplantation/hepatology
Follow-Up Studies
Zdroj: American Journal of Transplantation. 18:3007-3020
ISSN: 1600-6135
Popis: Acute graft-versus-host disease (GVHD) after liver transplant (LTx) is a rare complication with a high mortality rate. Recently, monoclonal antibody (mAb) treatment, specifically with anti-interleukin 2 receptor antibodies (IL2RAb) and anti-tumor necrosis factor-α antibodies (TNFAb), has gained increasing interest. However, evidence is mostly limited to case reports and the efficacy remains unclear. Here, we describe 5 patients with LTx-associated GVHD from our center and provide the results of our systematic literature review to evaluate the potential therapeutic benefit of IL2RAb/TNFAb treatment. Of the combined population of 155 patients (5 in our center and 150 through systematic search), 24 were given mAb (15.5%)-4 with TNFAb (2.6%) and 17 with IL2RAb (11%) ("mAb group")-and compared with patients who received other treatments (referred to as "no-mAb group"). Two-sided Fisher exact tests revealed a better survival when comparing treatment with mAb versus no-mAb (11/24 vs 27/131; P = .018), TNFAb versus no-mAb (3/4 vs 27/131; P = .034), and IL2RAb versus no-mAb (8/17 vs 27/131; P = .029). This systematic review suggests a beneficial effect of mAb treatment and a promising role for TNFAb and IL2RAb as a first-line strategy to treat LTx-associated acute GVHD. ispartof: AMERICAN JOURNAL OF TRANSPLANTATION vol:18 issue:12 pages:3007-3020 ispartof: location:United States status: published
Databáze: OpenAIRE
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