Updated Experience with Inolimomab as Treatment for Corticosteroid-Refractory Acute Graft-versus-Host Disease

Refractory acute graft-versus-host disease (aGVHD) remains an important cause of mortality after allogeneic stem cell transplantation. No standard therapy exists once steroids fail to obtain a good response. In 2006, our group published a series of patients who received inolimomab, an anti-interleuk...

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Autores: García Cadenas, Irene|||0000-0002-2994-9055, Valcárcel, David|||0000-0002-8747-078X, Martino Bofarull, Rodrigo|||0000-0001-5143-4042, Piñana, José Luis|||0000-0001-8533-2562, Novelli, Silvana|||0000-0001-8750-0195, Esquirol, Albert|||0000-0002-6062-5980, Garrido Diaz, Ana|||0000-0002-5297-8946, Moreno Martinez, Maria Estela|||0000-0001-6752-873X, Granell, Miquel|||0000-0002-0366-3673, Moreno, Carol|||0000-0003-3275-0271, Saavedra, Silvana|||0000-0001-5699-0531, Briones Meijide, Javier|||0000-0003-2750-3735, Brunet, Salut|||0000-0003-0491-1672, Sierra, Jorge|||0000-0002-7966-0356
Formato: artículo
Fecha de publicación:2013
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:303828
Acesso em linha:https://ddd.uab.cat/record/303828
https://dx.doi.org/urn:doi:10.1016/j.bbmt.2012.11.012
Access Level:acceso abierto
Palavra-chave:Acute graft-versus-host disease
Allogeneic stem cell transplantation
Anti-interleukin-2R
Inolimomab
Steroid refractory
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spelling Updated Experience with Inolimomab as Treatment for Corticosteroid-Refractory Acute Graft-versus-Host DiseaseGarcía Cadenas, Irene|||0000-0002-2994-9055Valcárcel, David|||0000-0002-8747-078XMartino Bofarull, Rodrigo|||0000-0001-5143-4042Piñana, José Luis|||0000-0001-8533-2562Novelli, Silvana|||0000-0001-8750-0195Esquirol, Albert|||0000-0002-6062-5980Garrido Diaz, Ana|||0000-0002-5297-8946Moreno Martinez, Maria Estela|||0000-0001-6752-873XGranell, Miquel|||0000-0002-0366-3673Moreno, Carol|||0000-0003-3275-0271Saavedra, Silvana|||0000-0001-5699-0531Briones Meijide, Javier|||0000-0003-2750-3735Brunet, Salut|||0000-0003-0491-1672Sierra, Jorge|||0000-0002-7966-0356Acute graft-versus-host diseaseAllogeneic stem cell transplantationAnti-interleukin-2RInolimomabSteroid refractoryRefractory acute graft-versus-host disease (aGVHD) remains an important cause of mortality after allogeneic stem cell transplantation. No standard therapy exists once steroids fail to obtain a good response. In 2006, our group published a series of patients who received inolimomab, an anti-interleukin-2 receptor monoclonal antibody, as salvage therapy with initial encouraging results. In this update, we analyzed a larger group of patients with prolonged follow-up. Ninety-two consecutive patients were treated with inolimomab at our center between April 1999 and December 2011. Overall response rate was 42% (complete response in 14%) on day +30. Predictors of failure to respond in the multivariate analysis were overall aGVHD grade IV, instauration of inolimomab before day 15 of aGVHD diagnosis, and severe lymphopenia. Patients without gastrointestinal involvement appeared to do better, with a 70% response rate compared with 39% in patients with gastrointestinal involvement (P =.06). However, the 2-year overall survival rate was of 18% for the entire cohort (95% confidence interval, 10% to 26%) and 33% for day 30 responders (95% confidence interval, 25% to 40%) and Acute GVHD was the main cause of death (49%) followed by opportunistic infections (27%). Results of this update show that although inolimomab is a well-tolerated drug with a moderate number of short-term responses, it is associated with long-term survival in only one-third of responding patients. These data highlight the need to investigate new rescue treatments with sustained effect and the importance of reporting long-term outcomes in GVHD studies. © 2013 American Society for Blood and Marrow Transplantation.Universitat Autònoma de Barcelona. Departament de Medicina 22013-01-0120132013-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/303828https://dx.doi.org/urn:doi:10.1016/j.bbmt.2012.11.012reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3038282026-06-06T12:50:31Z
dc.title.none.fl_str_mv Updated Experience with Inolimomab as Treatment for Corticosteroid-Refractory Acute Graft-versus-Host Disease
title Updated Experience with Inolimomab as Treatment for Corticosteroid-Refractory Acute Graft-versus-Host Disease
spellingShingle Updated Experience with Inolimomab as Treatment for Corticosteroid-Refractory Acute Graft-versus-Host Disease
García Cadenas, Irene|||0000-0002-2994-9055
Acute graft-versus-host disease
Allogeneic stem cell transplantation
Anti-interleukin-2R
Inolimomab
Steroid refractory
title_short Updated Experience with Inolimomab as Treatment for Corticosteroid-Refractory Acute Graft-versus-Host Disease
title_full Updated Experience with Inolimomab as Treatment for Corticosteroid-Refractory Acute Graft-versus-Host Disease
title_fullStr Updated Experience with Inolimomab as Treatment for Corticosteroid-Refractory Acute Graft-versus-Host Disease
title_full_unstemmed Updated Experience with Inolimomab as Treatment for Corticosteroid-Refractory Acute Graft-versus-Host Disease
title_sort Updated Experience with Inolimomab as Treatment for Corticosteroid-Refractory Acute Graft-versus-Host Disease
dc.creator.none.fl_str_mv García Cadenas, Irene|||0000-0002-2994-9055
Valcárcel, David|||0000-0002-8747-078X
Martino Bofarull, Rodrigo|||0000-0001-5143-4042
Piñana, José Luis|||0000-0001-8533-2562
Novelli, Silvana|||0000-0001-8750-0195
Esquirol, Albert|||0000-0002-6062-5980
Garrido Diaz, Ana|||0000-0002-5297-8946
Moreno Martinez, Maria Estela|||0000-0001-6752-873X
Granell, Miquel|||0000-0002-0366-3673
Moreno, Carol|||0000-0003-3275-0271
Saavedra, Silvana|||0000-0001-5699-0531
Briones Meijide, Javier|||0000-0003-2750-3735
Brunet, Salut|||0000-0003-0491-1672
Sierra, Jorge|||0000-0002-7966-0356
author García Cadenas, Irene|||0000-0002-2994-9055
author_facet García Cadenas, Irene|||0000-0002-2994-9055
Valcárcel, David|||0000-0002-8747-078X
Martino Bofarull, Rodrigo|||0000-0001-5143-4042
Piñana, José Luis|||0000-0001-8533-2562
Novelli, Silvana|||0000-0001-8750-0195
Esquirol, Albert|||0000-0002-6062-5980
Garrido Diaz, Ana|||0000-0002-5297-8946
Moreno Martinez, Maria Estela|||0000-0001-6752-873X
Granell, Miquel|||0000-0002-0366-3673
Moreno, Carol|||0000-0003-3275-0271
Saavedra, Silvana|||0000-0001-5699-0531
Briones Meijide, Javier|||0000-0003-2750-3735
Brunet, Salut|||0000-0003-0491-1672
Sierra, Jorge|||0000-0002-7966-0356
author_role author
author2 Valcárcel, David|||0000-0002-8747-078X
Martino Bofarull, Rodrigo|||0000-0001-5143-4042
Piñana, José Luis|||0000-0001-8533-2562
Novelli, Silvana|||0000-0001-8750-0195
Esquirol, Albert|||0000-0002-6062-5980
Garrido Diaz, Ana|||0000-0002-5297-8946
Moreno Martinez, Maria Estela|||0000-0001-6752-873X
Granell, Miquel|||0000-0002-0366-3673
Moreno, Carol|||0000-0003-3275-0271
Saavedra, Silvana|||0000-0001-5699-0531
Briones Meijide, Javier|||0000-0003-2750-3735
Brunet, Salut|||0000-0003-0491-1672
Sierra, Jorge|||0000-0002-7966-0356
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona. Departament de Medicina
dc.subject.none.fl_str_mv Acute graft-versus-host disease
Allogeneic stem cell transplantation
Anti-interleukin-2R
Inolimomab
Steroid refractory
topic Acute graft-versus-host disease
Allogeneic stem cell transplantation
Anti-interleukin-2R
Inolimomab
Steroid refractory
description Refractory acute graft-versus-host disease (aGVHD) remains an important cause of mortality after allogeneic stem cell transplantation. No standard therapy exists once steroids fail to obtain a good response. In 2006, our group published a series of patients who received inolimomab, an anti-interleukin-2 receptor monoclonal antibody, as salvage therapy with initial encouraging results. In this update, we analyzed a larger group of patients with prolonged follow-up. Ninety-two consecutive patients were treated with inolimomab at our center between April 1999 and December 2011. Overall response rate was 42% (complete response in 14%) on day +30. Predictors of failure to respond in the multivariate analysis were overall aGVHD grade IV, instauration of inolimomab before day 15 of aGVHD diagnosis, and severe lymphopenia. Patients without gastrointestinal involvement appeared to do better, with a 70% response rate compared with 39% in patients with gastrointestinal involvement (P =.06). However, the 2-year overall survival rate was of 18% for the entire cohort (95% confidence interval, 10% to 26%) and 33% for day 30 responders (95% confidence interval, 25% to 40%) and Acute GVHD was the main cause of death (49%) followed by opportunistic infections (27%). Results of this update show that although inolimomab is a well-tolerated drug with a moderate number of short-term responses, it is associated with long-term survival in only one-third of responding patients. These data highlight the need to investigate new rescue treatments with sustained effect and the importance of reporting long-term outcomes in GVHD studies. © 2013 American Society for Blood and Marrow Transplantation.
publishDate 2013
dc.date.none.fl_str_mv 2
2013-01-01
2013
2013-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/303828
https://dx.doi.org/urn:doi:10.1016/j.bbmt.2012.11.012
url https://ddd.uab.cat/record/303828
https://dx.doi.org/urn:doi:10.1016/j.bbmt.2012.11.012
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
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https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
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dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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