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Treatment of steroid‐refractory chronic graft‐versus‐host disease with imatinib: Real‐life experience of the Spanish group of hematopoietic transplantation (GETH)
Author(s) -
Parra Salinas Ingrid,
Bermudez Aranzazu,
López Corral Lucia,
Lopez Godino Oriana,
MólesPoveda Paula,
Martín Guillermo,
Costilla Barriga Lissette,
Ferrá Coll Christelle,
MárquezMalaver Francisco,
Ortí Guillermo,
Zudaire Ripa Maria Teresa,
Rifon Jose,
Martinez Carmen
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14255
Subject(s) - medicine , discontinuation , imatinib , toxicity , refractory (planetary science) , adverse effect , graft versus host disease , gastroenterology , gastrointestinal tract , surgery , transplantation , hematopoietic stem cell transplantation , lung , physics , myeloid leukemia , astrobiology
Treatment of steroid‐refractory chronic graft‐versus‐host disease (cGVHD) is a challenge. Here, we describe a retrospective analysis of 66 patients with steroid‐refractory cGVHD treated with imatinib (starting dose of 100 mg in 70% of patients; maximum dose of 100‐200 mg in 74%). Most patients had multi‐organ involvement (≥2 organs, 83%), with the most affected being skin (85%), oral mucosa (55%), eyes (42%), and lungs (33%). The overall response rate was 41% (21 partial and three complete responses). The organ with the best response rate was the skin (46%), followed by gastrointestinal tract (43%), liver (41%), the oral mucosa (36%), eyes (29%), and lungs (18%). Imatinib led to steroid tapering in 17/38 patients. Twenty‐five (38%) patients experienced imatinib‐related adverse events, comprising extra‐hematologic toxicity ( n = 24, 36%) and hematologic toxicity ( n = 6, 9%). No cases of grade 4‐5 toxicity were reported. The main causes of imatinib discontinuation were treatment failure (52%) and toxicity (9%). After a median follow‐up of 41 months, the 3‐year overall survival was 81%, with no difference between imatinib responders and non‐responders. These real‐life results show that imatinib is safe and has moderate efficacy in patients with heavily pre‐treated cutaneous sclerotic cGVHD; however, activity against lung cGVHD is very limited.