Evaluation of infliximab as second-line treatment of acute graft versus host disease -validating response on day 7 and 28 as predictors of survival
Identifieur interne : 000E25 ( Main/Exploration ); précédent : 000E24; suivant : 000E26Evaluation of infliximab as second-line treatment of acute graft versus host disease -validating response on day 7 and 28 as predictors of survival
Auteurs : Marietta Nygaard [Danemark] ; Niels Smedegaard Andersen [Danemark] ; Claus Ernst Moser [Danemark] ; Gitte Olesen [Danemark] ; Ida Marie Schj Dt [Danemark] ; Carsten Heilmann [Danemark] ; Henrik Sengel V [Danemark]Source :
- Bone Marrow Transplantation [ 0268-3369 ] ; 2018.
Abstract
Several immunosuppressive drugs have been proposed for second-line treatment of steroid-refractory acute graft versus host disease (aGvHD) after allogeneic hematopoietic stem cell transplantation. However, the studies on these drugs are small, retrospective, uncontrolled and use different endpoints. Therefore, it remains unknown which treatment is superior. We retrospectively evaluated 68 consecutive patients treated with infliximab for aGvHD. We adhered to recently proposed guidelines for aGvHD trials and thus evaluated response on day 7 and 28. Furthermore, we assessed the composite endpoint 6 months freedom from treatment failure (6MFTF). The majority of patients had grade III-IV aGvHD. We found that 41 patients (60%) responded on day 7 and 31 patients (46%) on day 28. Twenty-four patients (35%) achieved 6MFTF. The main reasons for failure within 6 months were death (
Url:
DOI: 10.1038/s41409-018-0099-3
PubMed: 29391524
PubMed Central: 7086567
Affiliations:
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as second-line treatment of acute graft versus host disease -validating response on day 7 and 28 as predictors of survival</title><author><name sortKey="Nygaard, Marietta" sort="Nygaard, Marietta" uniqKey="Nygaard M" first="Marietta" last="Nygaard">Marietta Nygaard</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0646 7373</institution-id><institution-id institution-id-type="GRID">grid.4973.9</institution-id><institution>Department of Hematology,</institution><institution>National University Hospital,</institution></institution-wrap>Rigshospitalet, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Rigshospitalet</wicri:regionArea></affiliation></author><author><name sortKey="Andersen, Niels Smedegaard" sort="Andersen, Niels Smedegaard" uniqKey="Andersen N" first="Niels Smedegaard" last="Andersen">Niels Smedegaard Andersen</name><affiliation wicri:level="1"><nlm:aff 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xml:lang="fr">Danemark</country><wicri:regionArea>Rigshospitalet</wicri:regionArea></affiliation></author><author><name sortKey="Olesen, Gitte" sort="Olesen, Gitte" uniqKey="Olesen G" first="Gitte" last="Olesen">Gitte Olesen</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0646 7373</institution-id><institution-id institution-id-type="GRID">grid.4973.9</institution-id><institution>Department of Hematology,</institution><institution>National University Hospital,</institution></institution-wrap>Rigshospitalet, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Rigshospitalet</wicri:regionArea></affiliation></author><author><name sortKey="Schj Dt, Ida Marie" sort="Schj Dt, Ida Marie" uniqKey="Schj Dt I" first="Ida Marie" last="Schj Dt">Ida Marie Schj Dt</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0646 7373</institution-id><institution-id institution-id-type="GRID">grid.4973.9</institution-id><institution>Department of Hematology,</institution><institution>National University Hospital,</institution></institution-wrap>Rigshospitalet, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Rigshospitalet</wicri:regionArea></affiliation></author><author><name sortKey="Heilmann, Carsten" sort="Heilmann, Carsten" uniqKey="Heilmann C" first="Carsten" last="Heilmann">Carsten Heilmann</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0646 7373</institution-id><institution-id institution-id-type="GRID">grid.4973.9</institution-id><institution>Department of Hematology,</institution><institution>National University Hospital,</institution></institution-wrap>Rigshospitalet, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Rigshospitalet</wicri:regionArea></affiliation></author><author><name sortKey="Sengel V, Henrik" sort="Sengel V, Henrik" uniqKey="Sengel V H" first="Henrik" last="Sengel V">Henrik Sengel V</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0646 7373</institution-id><institution-id institution-id-type="GRID">grid.4973.9</institution-id><institution>Department of Hematology,</institution><institution>National University Hospital,</institution></institution-wrap>Rigshospitalet, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Rigshospitalet</wicri:regionArea></affiliation></author></analytic><series><title level="j">Bone Marrow Transplantation</title><idno type="ISSN">0268-3369</idno><idno type="eISSN">1476-5365</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="Par1">Several immunosuppressive drugs have been proposed for second-line treatment of steroid-refractory acute graft versus host disease (aGvHD) after allogeneic hematopoietic stem cell transplantation. However, the studies on these drugs are small, retrospective, uncontrolled and use different endpoints. Therefore, it remains unknown which treatment is superior. We retrospectively evaluated 68 consecutive patients treated with infliximab for aGvHD. We adhered to recently proposed guidelines for aGvHD trials and thus evaluated response on day 7 and 28. Furthermore, we assessed the composite endpoint 6 months freedom from treatment failure (6MFTF). The majority of patients had grade III-IV aGvHD. We found that 41 patients (60%) responded on day 7 and 31 patients (46%) on day 28. Twenty-four patients (35%) achieved 6MFTF. The main reasons for failure within 6 months were death (<italic>n</italic> = 31) or additional immunosuppression (<italic>n</italic> = 16). By six and 24 months, 44 and 34% of the patients were alive respectively. Patients with response to infliximab on day 7 and 28 had significantly higher overall survival (OS) probability than non-responders. We show that response on day 7 and 28 identifies high and low risk groups. Patients who fail to respond should be identified early and offered alternative therapy.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Martin, Pj" uniqKey="Martin P">PJ Martin</name></author><author><name sortKey="Rizzo, Jd" uniqKey="Rizzo J">JD Rizzo</name></author><author><name sortKey="Wingard, Jr" uniqKey="Wingard J">JR Wingard</name></author><author><name sortKey="Ballen, K" uniqKey="Ballen K">K Ballen</name></author><author><name sortKey="Curtin, Pt" uniqKey="Curtin P">PT Curtin</name></author><author><name sortKey="Cutler, C" uniqKey="Cutler C">C Cutler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Martin, Pj" uniqKey="Martin P">PJ Martin</name></author><author><name sortKey="Inamoto, Y" uniqKey="Inamoto Y">Y Inamoto</name></author><author><name sortKey="Flowers, Med" uniqKey="Flowers M">MED Flowers</name></author><author><name sortKey="Carpenter, Pa" uniqKey="Carpenter P">PA 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sortKey="Levine, Je" uniqKey="Levine J">JE Levine</name></author><author><name sortKey="Logan, B" uniqKey="Logan B">B Logan</name></author><author><name sortKey="Wu, J" uniqKey="Wu J">J Wu</name></author><author><name sortKey="Alousi, Am" uniqKey="Alousi A">AM Alousi</name></author><author><name sortKey="Ho, V" uniqKey="Ho V">V Ho</name></author><author><name sortKey="Bola Os Meade, J" uniqKey="Bola Os Meade J">J Bolaños-Meade</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Marty, Fm" uniqKey="Marty F">FM Marty</name></author><author><name sortKey="Lee, Sj" uniqKey="Lee S">SJ Lee</name></author><author><name sortKey="Fahey, Mm" uniqKey="Fahey M">MM Fahey</name></author><author><name sortKey="Alyea, Ep" uniqKey="Alyea E">EP Alyea</name></author><author><name sortKey="Soiffer, Rj" uniqKey="Soiffer R">RJ Soiffer</name></author><author><name sortKey="Antin, Jh" uniqKey="Antin J">JH Antin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Garcia Cadenas, I" uniqKey="Garcia Cadenas I">I García-Cadenas</name></author><author><name sortKey="Rivera, I" uniqKey="Rivera I">I Rivera</name></author><author><name sortKey="Martino, R" uniqKey="Martino R">R Martino</name></author><author><name sortKey="Esquirol, A" uniqKey="Esquirol A">A Esquirol</name></author><author><name sortKey="Barba, P" uniqKey="Barba P">P Barba</name></author><author><name sortKey="Novelli, S" uniqKey="Novelli S">S Novelli</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Danemark</li></country></list><tree><country name="Danemark"><noRegion><name sortKey="Nygaard, Marietta" sort="Nygaard, Marietta" uniqKey="Nygaard M" first="Marietta" last="Nygaard">Marietta Nygaard</name></noRegion><name sortKey="Andersen, Niels Smedegaard" sort="Andersen, Niels Smedegaard" uniqKey="Andersen N" first="Niels Smedegaard" last="Andersen">Niels Smedegaard Andersen</name><name sortKey="Heilmann, Carsten" sort="Heilmann, Carsten" uniqKey="Heilmann C" first="Carsten" last="Heilmann">Carsten Heilmann</name><name sortKey="Moser, Claus Ernst" sort="Moser, Claus Ernst" uniqKey="Moser C" first="Claus Ernst" last="Moser">Claus Ernst Moser</name><name sortKey="Olesen, Gitte" sort="Olesen, Gitte" uniqKey="Olesen G" first="Gitte" last="Olesen">Gitte Olesen</name><name sortKey="Schj Dt, Ida Marie" sort="Schj Dt, Ida Marie" uniqKey="Schj Dt I" first="Ida Marie" last="Schj Dt">Ida Marie Schj Dt</name><name sortKey="Sengel V, Henrik" sort="Sengel V, Henrik" uniqKey="Sengel V H" first="Henrik" last="Sengel V">Henrik Sengel V</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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