Faculty Collaboration Database

Tocilizumab for the treatment of severe steroid-refractory acute graft-versus-host disease of the lower gastrointestinal tract. Bone Marrow Transplant 2019 Feb;54(2):212-217

Date

05/26/2018

Pubmed ID

29795429

DOI

10.1038/s41409-018-0236-z

Scopus ID

2-s2.0-85047331089 (requires institutional sign-in at Scopus site)   31 Citations

Abstract

Steroid-refractory (SR) acute gastrointestinal (GI) graft-versus-host disease (GVHD) is associated with significant mortality in allogeneic hematopoietic cell transplantation recipients. We retrospectively evaluated the efficacy of tocilizumab for the treatment of SR biopsy-proven acute lower GI GVHD in 16 consecutive adult transplant recipients between October 2015 and July 2016. Tocilizumab 8 mg/kg was administered every 2 weeks until achievement of complete response, defined as resolution of all manifestations of GI GVHD, or until patients had progression or initiation of other therapy. Ten of 16 patients (62.5%; 95% CI, 0.39-82) achieved a complete response after a median time of 11 days (range, 2-28 days) from tocilizumab initiation. The median time to response onset (improvement in stage by at least 1) was 1 day (range, 1-4 days). Tocilizumab was administered at a median of 9 days (range, 3-75 days) from GVHD diagnosis and 10 days (range, 3-75 days) from initiation of high-dose steroids. At a median follow-up of 7.6 months (range, 0.8-27.7 months) from initiation of tocilizumab, 6/16 (37.5%) patients are alive and free of their underlying hematologic malignancy. Tocilizumab appears to be a highly active agent for the treatment of severe SR lower GI acute GVHD.

Author List

Ganetsky A, Frey NV, Hexner EO, Loren AW, Gill SI, Luger SM, Mangan JK, Martin ME, Babushok DV, Drobyski WR, Smith J, Timlin C, Freyer CW, Stadtmauer EA, Porter DL

Author

William R. Drobyski MD Professor in the Medicine department at Medical College of Wisconsin

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

Adult
Aged
Antibodies, Monoclonal, Humanized
Female
Gastrointestinal Diseases
Graft vs Host Disease
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Lower Gastrointestinal Tract
Male
Middle Aged
Retrospective Studies
Steroids
Survival Analysis
Time Factors
Treatment Outcome
Young Adult