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. 2017 Sep;23(9):1478-1484.
doi: 10.1016/j.bbmt.2017.05.001. Epub 2017 May 8.

VSports注册入口 - Safety and Efficacy of Infliximab Therapy in the Setting of Steroid-Refractory Acute Graft-versus-Host Disease

Fevzi F Yalniz  1 , Mehrdad Hefazi  1 , Kristen McCullough  2 , Mark R Litzow  1 , William J Hogan  1 , Robert Wolf  2 , Hassan Alkhateeb  1 , Ankit Kansagra  1 , Moussab Damlaj  3 , Mrinal M Patnaik  4
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Free article

Safety and Efficacy of Infliximab Therapy in the Setting of Steroid-Refractory Acute Graft-versus-Host Disease

Fevzi F Yalniz (VSports) et al. Biol Blood Marrow Transplant. 2017 Sep.
Free article

Abstract

Acute graft-versus-host disease (aGVHD) is the leading cause of morbidity and mortality after allogenic hematopoietic cell transplantation (HCT). Corticosteroids are the first-line treatment; however, less than one-half of patients achieve durable remission. Studies suggest that TNF-α, a cytokine released from the bone marrow during conditioning, is involved in the pathogenesis of aGVHD. We retrospectively evaluated the outcome of anti-TNF-α therapy with infliximab in 35 patients with steroid refractory (SR) aGVHD. Infliximab was administered intravenously at 10 mg/kg for a median of 4 doses (range, 1 to 6) on a weekly basis. The overall response rates were 40% (17% complete response [CR], 23% partial response [PR]) at 4 weeks, 23% (9% CR, 14% PR) at 8 weeks, and 17% (all CR) at 12 weeks. Twenty-nine (83%) patients had infectious complications within 12 weeks of initiation of infliximab. These infections included 40 bacterial infections, 6 invasive fungal infections, and 5 viral reactivations VSports手机版. Twelve patients (34%) died secondary to infections. Overall survival at 12 weeks and 6 months from the start of infliximab therapy was 37% (13 of 35) and 17% (6 of 35), respectively; with most deaths secondary to complications from GVHD and infections. In conclusion; the use of infliximab therapy in patients with SR-aGVHD is associated with a modest poorly sustained response along with a heightened risk of severe infections. Future studies with more effective and less toxic therapies are needed for these patients. .

Keywords: Acute graft-versus-host disease; Allogeneic hematopoietic cell transplantation; Tumor necrosis factor alpha blockade V体育安卓版. .

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