Imatinib for refractory chronic graft-versus-host disease with fibrotic features
2009; Elsevier BV; Volume: 114; Issue: 3 Linguagem: Inglês
10.1182/blood-2009-02-204156
ISSN1528-0020
AutoresAttilio Olivieri, Franco Locatelli, Marco Zecca, Adele Sanna, Michele Cimminiello, Roberto Raimondi, Guido Gini, Nicola Mordini, Adriana Balduzzi, Pietro Leoni, Armando Gabrielli, Andrea Bacigalupo,
Tópico(s)Eosinophilic Disorders and Syndromes
ResumoAbstract We previously reported that patients with fibrotic, chronic graft-versus-host disease (cGVHD) have antibodies activating the platelet-derived growth factor receptor pathway. Because this pathway can be inhibited by imatinib, we performed a pilot study including 19 patients with refractory cGVHD, given imatinib at a starting dose of 100 mg per day. All patients had active cGVHD with measurable involvement of skin or other districts and had previously failed at least 2 treatment lines. Patient median age was 29 years (range, 10-62 years), and median duration of cGvHD was 37 months (range, 4-107 months). The organs involved were skin (n = 17), lung (n = 11), and bowel (n = 5); 15 patients had sicca syndrome. Imatinib-related, grade 3 to 4 toxicity included fluid retention, infections, and anemia. Imatinib was discontinued in 8 patients: in 3 because of toxicity and in 5 because of lack of response (n = 3) or relapse of malignancy (n = 2). Overall response rate at 6 months was 79%, with 7 complete remissions (CRs) and 8 partial remissions (PRs). With a median follow-up of 17 months, 16 patients are alive, 14 still in CR or PR. The 18-month probability of overall survival is 84%. This study suggests that imatinib is a promising treatment for patients with refractory fibrotic cGVHD.
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