Faculty Collaboration Database

Tocilizumab as first-line therapy for steroid-refractory acute graft-versus-host-disease: analysis of a single-center experience. Leuk Lymphoma 2019 Sep;60(9):2223-2229

Date

02/16/2019

Pubmed ID

30764681

DOI

10.1080/10428194.2019.1573996

Scopus ID

2-s2.0-85061930316 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

Acute graft-versus-host-disease (aGVHD) is a complication after allogeneic stem cell transplant. After the failure of treatment with high dose corticosteroids, steroid-refractory aGVHD (SR aGVHD) is associated with high rates of mortality. Tocilizumab has evidence of activity in SR aGVHD. For patients ineligible for trials, the OSU James Comprehensive Cancer Center has been utilizing tocilizumab as first-line therapy for SR aGVHD. We retrospectively report on 15 patients who received tocilizumab. aGVHD grading and responses were based on consensus criteria. Median age at transplant was 49 years. Median time to tocilizumab administration was 9 days (range, 3-16). Six patients had complete responses (40%) with a resolution of aGVHD. From the last contact, median overall survival for responders was not yet reached vs. 31 days for non-responders (p = .0002). Patients with skin and/or GI aGVHD demonstrated the greatest benefit. Patients with liver aGVHD did not respond. Future studies are needed to evaluate tocilizumab prior to steroid failure.

Author List

Yucebay F, Matthews C, Puto M, Li J, William B, Jaglowski SM, Penza SL, Vasu S, Benson DM, Andritsos LA, Devine SM, Efebera YA, Roddy JVF

Author

Samantha M. Jaglowski MD, MPH Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adult
Aged
Allografts
Antibodies, Monoclonal, Humanized
Disease Progression
Drug Resistance
Female
Glucocorticoids
Graft vs Host Disease
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Immunosuppressive Agents
Kaplan-Meier Estimate
Male
Middle Aged
Retrospective Studies
Transplantation, Homologous
Treatment Outcome
Young Adult