Cyclophosphamide for salvage therapy of chronic graft-versus-host disease: a retrospective analysis.
Adult
Aged
Chronic Disease
Cohort Studies
Cyclophosphamide
/ therapeutic use
Female
Follow-Up Studies
Graft vs Host Disease
/ diagnosis
Hematopoietic Stem Cell Transplantation
/ methods
Humans
Immunosuppressive Agents
/ therapeutic use
Male
Middle Aged
Retrospective Studies
Salvage Therapy
/ methods
Transplantation, Homologous
/ methods
Chronic graft versus host disease
Cyclophosphamide
Salvage therapy
Vasculitis-like cGvHD manifestation
Journal
Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
09
02
2020
accepted:
20
07
2020
pubmed:
28
7
2020
medline:
25
8
2020
entrez:
28
7
2020
Statut:
ppublish
Résumé
We retrospectively analyzed the safety and efficacy of cyclophosphamide (cyclo) for salvage treatment of chronic graft-versus-host disease (cGvHD) and cGvHD-associated (glomerulo-)nephritis at our center between 01/2010 and 11/2019. We identified 13 patients (pts) receiving cyclo for treatment of moderate (3/13) and severe (6/13) steroid-refractory cGvHD, cGvHD-associated (glomerulo-)nephritis (3/13), or vasculitis-like CNS manifestation of cGvHD (1/13). Cyclo was started on median day 509 (range 42-8193) after cGvHD onset; the median duration of application was 153 days (range 14-486) with 2/13 currently continuing treatment. The National Institute of Health organ grading and the intensity of immunosuppression (IS) were assessed at cyclo start and repeated after 3, 6, and 12 months. Response assessment was stopped at the start of any additional new IS. The median time of follow up was 407 days (range 86-1534). Best response was 1/13 CR, 6/13 PR, 4/13 SD, 1/13 MR, and 1/13 PD (ORR 54%). Significant and durable response was observed especially in cGvHD-associated (glomerulo-)nephritis (3/3). Infectious complications > CTCAE grade III were observed in 3/12 pts. During cyclo therapy, none of the pts suffered from recurrence of underlying malignancy. Overall, cyclo was relatively well tolerated and showed responses in heavily pretreated patients but requires further evaluation within clinical trials.
Identifiants
pubmed: 32715339
doi: 10.1007/s00277-020-04193-1
pii: 10.1007/s00277-020-04193-1
pmc: PMC7419371
doi:
Substances chimiques
Immunosuppressive Agents
0
Cyclophosphamide
8N3DW7272P
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2181-2190Subventions
Organisme : Deutsche Forschungsgemeinschaft
ID : TRR 221 - Project B10
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