Alemtuzumab as Treatment of Steroid-Refractory Acute Graft-versus-Host Disease: Results of a Phase II Study
We conducted a phase II trial to investigate the safety and efficacy of alemtuzumab in treating steroid-refractory acute graft-versus-host disease (aGVHD) grade II or higher after stem cell transplantation. Ten adult patients (6 with aGVHD grade III and 4 with aGVHD grade IV) were included in the st...
| Authors: | , , , , , , |
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| Format: | article |
| Publication Date: | 2009 |
| Country: | España |
| Institution: | Conselleria de Salut i Consum del Govern de les Illes Balears |
| Repository: | Docusalut |
| Language: | English |
| OAI Identifier: | oai:docusalut.com:20.500.13003/17379 |
| Online Access: | https://hdl.handle.net/20.500.13003/17379 |
| Access Level: | Open access |
| Keyword: | Gastrointestinal Diseases Steroids Skin Diseases Survival Rate Treatment Outcome Female Salvage Therapy Male Graft vs Host Disease Opportunistic Infections Alemtuzumab Middle Aged Antineoplastic Agents Cause of Death Aged Young Adult Acute Disease Antibodies, Neoplasm Hematopoietic Stem Cell Transplantation Adult Antibodies, Monoclonal Humans Antibodies, Monoclonal, Humanized Liver Diseases Enfermedad Aguda Anticuerpos Monoclonales Anciano Masculino Antineoplásicos Enfermedades Gastrointestinales Anticuerpos Monoclonales Humanizados Trasplante de Células Madre Hematopoyéticas Humanos Terapia Recuperativa Persona de Mediana Edad Adulto Joven Causas de Muerte Hepatopatías Femenino Infecciones Oportunistas Enfermedad Injerto contra Huésped Tasa de Supervivencia Esteroides Resultado del Tratamiento Anticuerpos Antineoplásicos Enfermedades de la Piel Adulto Acute graft-versus-host disease Allogeneic stem cell transplantation |
| Summary: | We conducted a phase II trial to investigate the safety and efficacy of alemtuzumab in treating steroid-refractory acute graft-versus-host disease (aGVHD) grade II or higher after stem cell transplantation. Ten adult patients (6 with aGVHD grade III and 4 with aGVHD grade IV) were included in the study. Nine patients had gastrointestinal tract involvement, 7 had skin involvement, and 5 had liver involvement. Five patients responded to treatment, 2 with complete response and 3 with partial response. Eight infectious events (4 of grade 3-4) and 7 cytomegalovirus (CMV) reactivations were observed. Six patients had grade 3-4 cytopenia. All 10 patients died (7 resulting from aGVHD progression, 2 from severe infection, and I from to leukemia relapse), at a median of 40 days (range, 4 to 88 days) after alemtuzumab treatment. Overall, our findings suggest that steroid-refractory aGVHD may be improved by treatment with alemtuzumab, but that this treatment does not overcome the dismal prognosis of patients with severe aGVHD, demonstrating the need for alternative therapies to treat this complication. |
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