title: Imatinib and dasatinib as salvage therapy for sclerotic chronic graft-vs-host disease.
abstract: OBJECTIVE
  To assess the toxicity, tolerance, steroid-sparing capacity, effectiveness, and response rate to imatinib and dasatinib for the treatment of severe sclerotic chronic graft-vs-host disease (scGVHD).
  
  
  METHODS
  This retrospective study analyzed 8 consecutive patients with severe refractory scGVHD who received salvage therapy with imatinib. Patients intolerant and/or refractory to imatinib received dasatinib treatment.
  
  
  RESULTS
  7 patients discontinued imatinib treatment (1 achieved complete response, 5 were resistant and/or intolerant, and 1 developed grade IV neutropenia) and 1 patient achieved prolonged partial response, but died due to an infectious complication while on treatment. 5 patients started dasatinib treatment (3 achieved partial responses and discontinued dasatinib, 1 achieved a durable partial response, but died due to a consecutive rapid pulmonary cGVHD progression and 1 with stable disease discontinued treatment due to gastroenteric intolerance). The response rate (partial and/or complete responses) for severe scGVHD was 25% for imatinib and 60% for dasatinib.
  
  
  CONCLUSIONS
  In our series, dasatinib was better tolerated, safer, steroid-sparing, and had a low incidence of infectious complications, which suggests that it may be a more effective therapeutic alternative for patients with refractory scGVHD than imatinib. Treatment of scGVHD with effective antifibrotic drugs such as TKI, which block the kinase fibrotic pathway, may be a safe and effective therapeutic option, but further studies are needed to confirm our findings.
authors.affiliation: Isabel Sánchez-Ortega, Department of Hematology, ICO - Hospital Duran i Reynals, Gran Via de L'Hospitalet, 199-203, Barcelona 08908, Spain, isanchez-ortega@iconcologia.net.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sánchez-Ortega
authors.forename: Rocío
authors.initials: R
authors.lastname: Parody
authors.forename: Octavio
authors.initials: O
authors.lastname: Servitje
authors.forename: Cristina
authors.initials: C
authors.lastname: Muniesa
authors.forename: Montserrat
authors.initials: M
authors.lastname: Arnan
authors.forename: Beatriz
authors.initials: B
authors.lastname: Patino
authors.forename: Anna
authors.initials: A
authors.lastname: Sureda
authors.forename: Rafael F
authors.initials: RF
authors.lastname: Duarte
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000069439:Dasatinib / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage / Q000627:therapeutic use*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016879:Salvage Therapy; D012598:Sclerosis / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate; D000069439:Dasatinib