Infliximab for managing steroid-refractory acute graft-versus-host disease.
Infliximab has demonstrated activity in the treatment of steroid-refractory acute graft-versus-host disease (aGVHD). We aimed to confirm the effectiveness of infliximab as a salvage therapy for steroid-refractory aGVHD. In a series of 52 patients, 71% of whom had grade III-IV aGVHD, only 15% achieved complete remission (CR) with the use of infliximab alone as salvage therapy. CR of aGVHD differed according to overall aGVHD grade at salvage (grade II, 5/15; grade III, 2/17; grade IV, 1/20; P=.03). Median overall survival (OS) was only 1.7 months (95% confidence interval [CI]=0.99 to 2.3 months). CR of aGVHD was significantly associated with OS, with a hazard ratio of 8.4 for death in those without CR (95% CI=3.6 to 19.6; P < .0001). This series demonstrates the limited activity of infliximab in patients with high-grade aGVHD. Further work is needed to identify effective therapy for aGVHD.
Pidala
Joseph
J
Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA. joseph.pidala@moffitt.org
Kim
Jongphil
J
Field
Teresa
T
McBride
Ali
A
Kharfan-Dabaja
Mohamed
M
Perkins
Janelle
J
Fernandez
Hugo
H
Perez
Lia
L
Ayala
Ernesto
E
Anasetti
Claudio
C
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy*; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D013256:Steroids / Q000494:pharmacology; D016896:Treatment Outcome; D055815:Young Adult
D000911:Antibodies, Monoclonal; D013256:Steroids; D000069285:Infliximab