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Infliximab for Managing Steroid-Refractory Acute Graft-versus-Host Disease

2009; Elsevier BV; Volume: 15; Issue: 9 Linguagem: Inglês

10.1016/j.bbmt.2009.05.019

1523-6536

Joseph Pidala, Jongphil Kim, Teresa Field, Ali McBride, Mohamed A. Kharfan‐Dabaja, Janelle Perkins, Hugo F. Fernández, Lia Perez, Ernesto Ayala, Claudio Anasetti,

Virus-based gene therapy research

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.