title: Basiliximab for the treatment of steroid-refractory acute graft-versus-host disease after unmanipulated HLA-mismatched/haploidentical hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Anti-CD(25) monoclonal antibodies (Mabs) have been evaluated for the treatment of steroid-refractory acute graft-versus-host disease (GVHD) in patients undergoing hematopoietic stem cell transplantation (HSCT) mainly with matched donors for years, but there is little attention concerning patients with unmanipulated human leukocyte antigen (HLA)-mismatched/haploidentical transplantations. We investigated the efficacy and safety of the chimeric Mab, basiliximab, to treat steroid-refractory acute GVHD after unmanipulated mismatched/haploidentical HSCT.
  
  
  METHODS
  Fifty-three patients who developed steroid-refractory acute GVHD between July 2005 and July 2009 were treated at our institute with basiliximab. No prisoners were used in this study.
  
  
  RESULTS
  Forty-six among 53 patients responded, including 37 complete remissions at a median response of 6 days from Mab initiation. There were 29 episodes of viral reactivations, 25 bacterial infections, and 11 probable fungal infections. Thirty-four out of 49 patients who could be evaluated developed chronic GVHD. Twenty-eight of 53 subjects (52.8%) were alive at a median follow-up of 16 months (range, 2-57) posttransplantation. The Kaplan-Meier probability of a 3-year event-free survival was 47.7%. The causes of death were infection alone (n = 15), progressive GVHD with infection (n = 3), relapse (n = 3), and other etiologies (n = 4).
  
  
  CONCLUSIONS
  These data suggested that basiliximab was effective to treat steroid-refractory acute GVHD after unmanipulated HLA-mismatched/haploidentical stem cell transplantation.
authors.affiliation: Peking University People's Hospital, Institute of Hematology, Beijing, China.
authors.forename: J Z
authors.initials: JZ
authors.lastname: Wang
authors.forename: K Y
authors.initials: KY
authors.lastname: Liu
authors.forename: L P
authors.initials: LP
authors.lastname: Xu
authors.forename: D H
authors.initials: DH
authors.lastname: Liu
authors.forename: W
authors.initials: W
authors.lastname: Han
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.forename: Y H
authors.initials: YH
authors.lastname: Chen
authors.forename: X H
authors.initials: XH
authors.lastname: Zhang
authors.forename: T
authors.initials: T
authors.lastname: Zhao
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: X J
authors.initials: XJ
authors.lastname: Huang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000077552:Basiliximab; D002648:Child; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000188:drug therapy*; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007239:Infections / Q000150:complications; D008297:Male; D008875:Middle Aged; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab