title: The use of basiliximab-infliximab combination for the treatment of severe gastrointestinal acute GvHD.
abstract: After allogeneic stem cell transplant, severe grade III-IV gastrointestinal (GI) acute GvHD is associated with significant morbidity and mortality, and generally results in poor outcomes. Salvage therapy for patients who fail steroid therapy is not well defined in the literature. In the current retrospective study, we reviewed our experience with the combination of basiliximab and infliximab in 21 patients with severe, grade III-IV GI acute GvHD of whom 16 met the definition for steroid-refractory disease. The overall response rate was 76%, with 43% CR at a median time of 21 days after beginning treatment. The survival at 1 year was 24%, with most deaths due to complications from GvHD and recurrence of primary disease. All five of the long-term survivors have chronic GvHD. On the basis of a review of the literature, this regimen does not seem to be significantly more effective than other strategies for severe GI GvHD and seems to be worse than the results reported for basiliximab alone. Future studies of single-agent basiliximab and newer agents are required.
authors.affiliation: Department of Pharmacy Services, Smilow Cancer Hospital at Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: M
authors.initials: M
authors.lastname: Nadeau
authors.affiliation: Department of Pharmacy Services, Smilow Cancer Hospital at Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: S
authors.initials: S
authors.lastname: Perreault
authors.affiliation: Department of Internal Medicine, Section of Hematology, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: S
authors.initials: S
authors.lastname: Seropian
authors.affiliation: Department of Internal Medicine, Section of Hematology, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: F
authors.initials: F
authors.lastname: Foss
authors.affiliation: Department of Internal Medicine, Section of Hematology, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: I
authors.initials: I
authors.lastname: Isufi
authors.affiliation: Department of Internal Medicine, Section of Hematology, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Cooper
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D064591:Allografts; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D000077552:Basiliximab; D018572:Disease-Free Survival; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy; D006801:Humans; D000069285:Infliximab / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012720:Severity of Illness Index; D033581:Stem Cell Transplantation; D015996:Survival Rate
chemical_list: D000911:Antibodies, Monoclonal; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D000069285:Infliximab