Effectiveness of ibrutinib in the management of chronic GVHD

IF 1.4 4区医学 Q4 HEMATOLOGY Transfusion and Apheresis Science Pub Date : 2025-02-01 DOI:10.1016/j.transci.2024.104052

Mehmet Ali Erkurt , Ahmet Sarici , Abdulkadir Sahin , Ilhami Berber , Gulten Korkmaz , Irfan Kuku , Mehmet Sinan Dal , Serdal Korkmaz , Turgay Ulas , Fevzi Altuntas

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Abstract

Objectives

Chronic graft-versus-host disease (cGVHD) represents a significant adverse event that may ensue following allogeneic hematopoietic stem cell transplantation (Allo-HSCT). In patients resistant to corticosteroids, which is the first-line treatment for cGVHD, ibrutinib is being evaluated as a potential treatment option. In this study, we aimed to share the findings of our multicenter study regarding the outcomes of ibrutinib treatment in patients with corticosteroid-resistant cGVHD who had previously received multiple systemic therapies.

Material and methods

A retrospective analysis was conducted to examine the clinical characteristics and outcomes of patients who received ibrutinib treatment for corticosteroid-resistant cGVHD after Allo-HSCT.

Results

A total of 24 patients diagnosed with cGVHD who received ibrutinib treatment were included in the study. The median age of the patients was 34.5 (20–67). The included patients were followed for a median of 6 (1–30) months. All patients had stem cells collected from the peripheral blood. Fifty percent of the patients had multiple organ involvement, while the other 50 % had single organ involvement. The most frequently affected organs were skin and liver. On average, patients received four (3–5) lines of systemic therapy before ibrutinib treatment. At week 24 of ibrutinib treatment, 10 patients (41.7 %) had a complete response, and 10 patients (41.7 %) had a partial response; at week 48, 8 patients (33.3 %) had a complete response, and 10 patients (41.7 %) had a partial response. The most common hematological side effect after ibrutinib treatment was thrombocytopenia in 5 out of 24 patients, while the most common non-hematological side effect was CMV infection in 6 out of 24 patients.

Conclusion

In patients with corticosteroid-resistant cGVHD, ibrutinib treatment has been demonstrated to be an efficacious option exhibiting an elevated overall response rate and a tolerable side effect profile.

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依鲁替尼治疗慢性GVHD的有效性。

目的：慢性移植物抗宿主病（cGVHD）是同种异体造血干细胞移植（alloo - hsct）后可能发生的重大不良事件。对糖皮质激素（cGVHD的一线治疗方法）有耐药性的患者，正在评估伊鲁替尼作为一种潜在的治疗选择。在这项研究中，我们的目的是分享我们的多中心研究结果，关于伊鲁替尼治疗皮质类固醇抵抗性cGVHD患者的结果，这些患者之前接受过多种全身治疗。材料和方法：回顾性分析Allo-HSCT后接受依鲁替尼治疗的糖皮质激素抵抗性cGVHD患者的临床特征和结局。结果：共纳入24例接受依鲁替尼治疗的cGVHD患者。患者年龄中位数为34.5岁（20-67岁）。纳入的患者随访时间中位数为6（1-30）个月。所有患者都从外周血中采集了干细胞。50%的患者有多个器官受累，而另外50% %有单个器官受累。最常受影响的器官是皮肤和肝脏。患者在伊鲁替尼治疗前平均接受4（3-5）行全身治疗。在伊鲁替尼治疗第24周时，10例患者（41.7 %）完全缓解，10例患者（41.7 %）部分缓解；在第48周，8名患者（33.3% %）完全缓解，10名患者（41.7 %）部分缓解。伊鲁替尼治疗后最常见的血液学副作用是24例患者中5例的血小板减少，而最常见的非血液学副作用是24例患者中6例的巨细胞病毒感染。结论：在皮质类固醇抵抗性cGVHD患者中，伊鲁替尼治疗已被证明是一种有效的选择，具有较高的总有效率和可耐受的副作用。

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来源期刊

Transfusion and Apheresis Science 医学-血液学

CiteScore

3.60

自引率

5.30%

发文量

181

审稿时长

42 days

期刊介绍： Transfusion and Apheresis Science brings comprehensive and up-to-date information to physicians and health care professionals involved in the rapidly changing fields of transfusion medicine, hemostasis and apheresis. The journal presents original articles relating to scientific and clinical studies in the areas of immunohematology, transfusion practice, bleeding and thrombotic disorders and both therapeutic and donor apheresis including hematopoietic stem cells. Topics covered include the collection and processing of blood, compatibility testing and guidelines for the use of blood products, as well as screening for and transmission of blood-borne diseases. All areas of apheresis - therapeutic and collection - are also addressed. We would like to specifically encourage allied health professionals in this area to submit manuscripts that relate to improved patient and donor care, technical aspects and educational issues. Transfusion and Apheresis Science features a "Theme" section which includes, in each issue, a group of papers designed to review a specific topic of current importance in transfusion and hemostasis for the discussion of topical issues specific to apheresis and focuses on the operators'' viewpoint. Another section is "What''s Happening" which provides informal reporting of activities in the field. In addition, brief case reports and Letters to the Editor, as well as reviews of meetings and events of general interest, and a listing of recent patents make the journal a complete source of information for practitioners of transfusion, hemostasis and apheresis science. Immediate dissemination of important information is ensured by the commitment of Transfusion and Apheresis Science to rapid publication of both symposia and submitted papers.