Ruxolitinib on acute graft-versus-host disease prophylaxis after modified donor lymphocyte infusion |
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| Institution: | 1. Department of Rheumatology, The Second Hospital of Shanxi Medical University, 030013 Taiyuan, Shanxi, China;2. Department of Pathology, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA 02212, USA;1. Nephrology Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia;2. Pathology Queensland, Brisbane, Queensland, Australia;1. School of Medicine, University of Electronic Science and Technology, China;2. Division of Nephrology, Sichuan Provincial People''s Hospital& Sichuan Academy of Sciences, University of Electronic Science and Technology, China;3. Department of nephrology, Bazhong Enyang District People''s Hospital, China;4. Department of Nephrology, The First people''s Hospital of Liangshan Yi Autonomous Prefecture, China;5. General Practice Center, Sichuan Provincial People''s Hospital& Sichuan Academy of Sciences, University of Electronic Science and Technology, China;1. Albany Medical Center, Albany, NY, United States of America;2. George Mason University, Fairfax, VA, United States of America;3. Division of Renal and Pancreatic Transplant Services, Albany Medical Center, Albany, NY, United States of America;1. Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, China;2. Department of Anesthesiology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin 300100, China;3. Department of Anesthesiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China;4. Department of General Surgery, Tianjin Public Security Hospital, Tianjin 300042, China;1. Department of Surgery, Division of Transplantation, SUNY Upstate Medical University, Syracuse, NY, USA;2. Department of Pathology and Laboratory Medicine, SUNY Upstate Medical University, Syracuse, NY, USA |
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| Abstract: | ObjectiveTo evaluate the effectiveness of ruxolitinib on acute graft-versus-host disease (aGVHD) prophylaxis and its impact on graft-versus-leukemia (GVL) effect in patients after modified donor lymphocyte infusion (mDLI).MethodsWe retrospectively included patients with relapsed leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT) who received ruxolitinib prophylaxis between October 2018 and April 2020. The incidence of aGVHD, disease-free survival (DFS), overall survival (OS), and treatment safety were evaluated.ResultsSeventeen patients were followed up for a median time of 8 months (range: 1–26 months). The incidence of aGVHD on Day 30 after mDLI was 41.2% and ranged from Grade 1 to 4; ten of 17 patients (58.8%) achieved a complete response (CR), and two (11.8%) had a partial response (PR). Cytomegalovirus (CMV) reactivation rate was 23.5%, and the median time from mDLI to CMV reactivation was 48.5 days. The mean DFS and OS after mDLI were 1.0 (95% CI 0.0–3.5) and 9.0 (95% CI 1.2–16.8) months, respectively. The causes of death for 10 patients were leukemia relapse (n = 5), aGVHD and septic shock (n = 3), intracranial lesion (n = 1), and COVID-19 (n = 1).ConclusionsWe reported encouraging results of ruxolitinib monotherapy in the prevention of aGVHD and maintenance of GVL for post-transplantation relapsed patients, even though being at high risk with poor initial prognosis. |
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