Etanercept for steroid-refractory acute graft-versus-host disease: A single center experience

PloS One
Cornelis N De JongAnnoek E C Broers

Abstract

Acute graft-versus-host disease (aGVHD) is an important complication of allogeneic stem cell transplantation (alloSCT). High dose glucocorticosteroids, are currently recommended as first-line treatment for grade II-IV aGVHD resulting in overall complete responses (CR) in 40%-50% of patients. No standard second-line regimen has been established. Different options have been reported, including anti-TNFα antibodies. We retrospectively reviewed the outcome of 15 patients with steroid-refractory (SR) aGVHD treated with etanercept at our institution. Patients were transplanted for a hematological malignancy and received either a myeloablative or a non-myeloablative conditioning regimen. Prophylaxis of GVHD consisted of cyclosporin A and mycophenolic acid. Acute GVHD was diagnosed at a median of 61 days post-transplantation. All patients had grade III aGVHD of the gut. Second-line treatment with etanercept was started at a median of 13 days after initiation of first-line therapy. Overall response rate was 53%, with CR in 3 patients and PR in 5 patients. Median overall survival after initiation of treatment with etanercept was 66 days (range 5-267) for the entire group. Median overall survival was 99 days (range 47-267 days) for respon...Continue Reading

References

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Citations

Apr 7, 2020·Expert Review of Hematology·Roman M Shapiro, Joseph H Antin
Apr 16, 2020·Expert Opinion on Investigational Drugs·Sameem M Abedin, Mehdi Hamadani
Apr 4, 2020·Leukemia·Florent MalardJoycelyn P Y Sim
May 16, 2020·Frontiers in Immunology·Stephanie Kim, Pavan Reddy

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