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Efficacy of the interleukin‐2 receptor antagonist basiliximab in steroid‐refractory acute graft‐ versus ‐host disease
Author(s) -
SchmidtHieber Martin,
Fietz Thomas,
Knauf Wolfgang,
Uharek Lutz,
Hopfenmüller Werner,
Thiel Eckhard,
Blau Igor Wolfgang
Publication year - 2005
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2005.05631.x
Subject(s) - basiliximab , medicine , refractory (planetary science) , immunosuppression , transplantation , gastroenterology , immunology , graft versus host disease , hematopoietic stem cell transplantation , biology , tacrolimus , astrobiology
Summary Acute graft‐ versus ‐host disease (aGVHD) occurs in up to 80% of patients who undergo allogeneic stem cell transplantation (SCT) and contributes significantly to transplant‐related mortality (TRM). We conducted a prospective phase II trial to assess the efficacy and feasibility of treating steroid‐refractory aGVHD with basiliximab, a chimaeric monoclonal antibody directed against the alpha chain of the interleukin‐2 (IL‐2) receptor. Basiliximab was administered intravenously at a dose of 20 mg on days 1 and 4. Twenty‐three patients were enrolled between October 1999 and July 2004. We found a primary overall response rate of 82·5% with four patients (17·5%) showing a complete response and 15 patients (65%) a partial response. Six patients were again treated successfully with an IL‐2 receptor antagonist because of recurrence of aGVHD. The rates of infections, chronic GVHD, malignancy recurrence and 1‐year TRM following immunosuppression with basiliximab were comparable with those found with other treatment modalities for aGVHD. We conclude that basiliximab is efficient and feasible for steroid‐refractory aGVHD and merits further evaluation.