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Alemtuzumab for Severe Steroid-Refractory Gastrointestinal Acute Graft-versus-Host Disease

2014; Elsevier BV; Volume: 20; Issue: 9 Linguagem: Inglês

10.1016/j.bbmt.2014.05.031

1523-6536

Mathieu Meunier, Claude‐Eric Bulabois, Anne Thiebaut‐Bertrand, Raphaël Itzykson, Martin Carré, Sylvain Carras, Frédéric Garban, J Cahn,

Immunotherapy and Immune Responses

Acute graft-versus-host disease (aGVHD) still remains the main cause of morbidity and mortality after allogeneic stem cell transplantation. Moreover, patients who did not respond to first-line treatment with glucocorticosteroids have a very poor outcome. Some studies suggested that alemtuzumab (a humanized monoclonal antibody against the CD52 antigen) might be effective for treatment of refractory aGVHD. Here we report a single-center experience with alemtuzumab in refractory gastrointestinal aGVHD. From September 2009 to April 2012 at the Grenoble medical university center, 24 patients who had presented a refractory gastrointestinal aGVHD to corticosteroid, or after another immunosuppressive drug, were retrospectively analyzed. Most patients (n = 19) presented stage 4 gastrointestinal aGVHD. Response to treatment (either complete or partial) was observed in 15 patients (62.4%). The overall survival rate at 1 year for all patients was 33.3% (95% confidence interval [CI], 15.9% to 51.9%) and for responders, 53.3% (95% CI, 26.3% to 74.4%). Two patients died from infection, 5 patients from recurrent GVHD, and 1 from an uncontrolled post-transplant lymphoproliferative disorder.