Encouraging results with inolimomab (anti-IL-2 receptor) as treatment for refractory acute graft-versus-host disease.
Inolimomab [corrected] an anti-interleukin-2 receptor (anti-IL-2R) monoclonal antibody, may be useful in the treatment of steroid-refractory acute graft-versus-host disease (aGVHD) by inhibiting 1 of its putative immunopathogenic pathways. We retrospectively analyzed 40 consecutive patients who received inolimomab [corrected] as salvage treatment for steroid refractory aGVHD at a single institution between June 1999 and December 2004. Inolimomab [corrected] was given intravenously at a dose of 11 mg/d for 3 consecutive days, followed by 5.5 mg/d for 7 consecutive days and then 5.5 mg every other day for 5 doses. No infusion-related side effects were noted. Twenty-three patients (58%) responded, including 15 (38%) complete and 8 (20%) partial responses. Median overall survival was 294 days (58-996 days) for responders versus 14 days for nonresponders (P < .001), with a 1 year probability of 59% vs 0% for overall survival (P < .0001). Patients without gastrointestinal (GI) involvement showed a higher response rate (100% versus 50% for those without versus with GI involvement, P = .03) In addition, patients who showed some response by day 15 had a higher overall survival (73 +/- 12% vs 24 +/- 12%, respectively, P = .02). The results of this study suggest that inolimomab [corrected] may be an effective salvage therapy for patients with steroid-refractory aGVHD, particularly for those without GI disease, and supports further studies with this agent in prospective controlled trials.
Piñana
Jose Luis
JL
Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain.
Valcárcel
David
D
Martino
Rodrigo
R
Moreno
M Estela
ME
Sureda
Anna
A
Briones
Javier
J
Brunet
Salut
S
Sierra
Jorge
J
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015375:Receptors, Interleukin-2 / Q000037:antagonists & inhibitors*; D012189:Retrospective Studies; D016879:Salvage Therapy; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D016019:Survival Analysis; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D015375:Receptors, Interleukin-2; C079843:inolimomab