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Fante, Matthias A. ; Holler, Barbara ; Weber, Daniela ; Angstwurm, Klemens ; Bergler, Tobias ; Holler, Ernst ; Edinger, Matthias ; Herr, Wolfgang ; Wertheimer, Tobias ; Wolff, Daniel

Cyclophosphamide for salvage therapy of chronic graft-versus-host disease: a retrospective analysis

Fante, Matthias A., Holler, Barbara, Weber, Daniela, Angstwurm, Klemens , Bergler, Tobias, Holler, Ernst, Edinger, Matthias, Herr, Wolfgang, Wertheimer, Tobias und Wolff, Daniel (2020) Cyclophosphamide for salvage therapy of chronic graft-versus-host disease: a retrospective analysis. Annals of Hematology 99, S. 2181-2190.

Veröffentlichungsdatum dieses Volltextes: 28 Jan 2021 09:09
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.44607


Zusammenfassung

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 ...

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.



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Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftAnnals of Hematology
Verlag:Springer
Ort der Veröffentlichung:NEW YORK
Band:99
Seitenbereich:S. 2181-2190
Datum2020
InstitutionenMedizin > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie)
Medizin > Abteilung für Nephrologie
Medizin > Lehrstuhl für Neurologie
Identifikationsnummer
WertTyp
10.1007/s00277-020-04193-1DOI
Stichwörter / KeywordsCONSENSUS DEVELOPMENT PROJECT; STEM-CELL TRANSPLANTATION; CLINICAL-TRIALS; CHRONIC GVHD; PHARMACOKINETICS; CHEMOTHERAPY; METABOLISM; DIAGNOSIS; CRITERIA; LUPUS; Chronic graft versus host disease; Vasculitis-like cGvHD manifestation; Salvage therapy; Cyclophosphamide
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetUnbekannt / Keine Angabe
An der Universität Regensburg entstandenJa
URN der UB Regensburgurn:nbn:de:bvb:355-epub-446076
Dokumenten-ID44607

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