Efficacy and tolerance of ruxolitinib in refractory sclerodermatous chronic graft‐versus‐host disease

Hurabielle, Charlotte; Fontbrune, Flore Sicre de; Robin, Marie; Coman, Téreza; Dhédin, Nathalie; Cassius, C.; Chasset, François; Masson, Adèle de; Michonneau, David; Bagot, Martine; Bergeron, Anne; Socié, Gèrard; Latour, Régis Peffault de; Bouaziz, Jean‐David

doi:10.1111/bjd.15593

Cited by 26 publications

(22 citation statements)

References 8 publications

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“…Among patients with refractory cGVHD, ORR was 57.1% (32/56) with 3.5% (2/56) obtaining CR. It is worth mentioning that, in the current study, the response rate reached 56% for cGVHD with skin involvement and sclerotic features, which is promising considering the limited therapeutic options for these patients [20]. Similarly, lung involvement is one of the most severe features of cGVHD.…”

Section: Discussionmentioning

confidence: 57%

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Ruxolitinib in refractory acute and chronic graft-versus-host disease: a multicenter survey study

Gomez

García‐Gutiérrez

Corral

et al. 2019

Bone Marrow Transplant

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Graft-versus-host disease is the main cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. First-line treatment is based on the use of high doses of corticosteroids. Unfortunately, second-line treatment for both acute and chronic graft-versus-host disease, remains a challenge. Ruxolitinib has been shown as an effective and safe treatment option for these patients. Seventy-nine patients received ruxolitinib and were evaluated in this retrospective and multicenter study. Twenty-three patients received ruxolitinib for refractory acute graft-versus-host disease after a median of 3 (range 1-5) previous lines of therapy. Overall response rate was 69.5% (16/23) which was obtained after a median of 2 weeks of treatment, and 21.7% (5/23) reached complete remission. Fifty-six patients were evaluated for refractory chronic graft-versus-host disease. The median number of previous lines of therapy was 3 (range 1-10). Overall response rate was 57.1% (32/56) with 3.5% (2/56) obtaining complete remission after a median of 4 weeks. Tapering of corticosteroids was possible in both acute (17/23, 73%) and chronic graft-versus-host disease (32/56, 57.1%) groups. Overall survival was 47% (CI: 23-67%) at 6 months for patients with aGVHD (62 vs 28% in responders vs non-responders) and 81% (CI: 63-89%) at 1 year for patients with cGVHD (83 vs 76% in responders vs non-responders). Ruxolitinib in the real life setting is an effective and safe treatment option for GVHD, with an ORR of 69.5% and 57.1% for refractory acute and chronic graftversus-host disease, respectively, in heavily pretreated patients.

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Section: Discussionmentioning

confidence: 57%

“…Responses for lung involvement were evaluated according to NIH scoring/staging/response assessment as part of standard clinical practice. Thirty-two patients (59.2%) could And gut involvement 7/10 (70) 2/10 (20) taper the doses of steroids. OS at 1 year was 81% (IC: 63-89) ( Fig.…”

Section: Ruxolitinib In Cgvhdmentioning

confidence: 99%

Ruxolitinib in refractory acute and chronic graft-versus-host disease: a multicenter survey study

Gomez

García‐Gutiérrez

Corral

et al. 2019

Bone Marrow Transplant

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“…Cutaneous manifestations have a broad clinical spectrum, including lichen planus-like eruption, scleroderma, xerosis and ichthyosis, poikiloderma, dyspigmentation, acral erythema, keratosis pilaris-like and papulosquamous eruptions, and psoriasiform and eczematous eruptions [3,4]. Although there are still no randomized studies demonstrating its efficacy, ruxolitinib, a JAK1/2 inhibitor, appears to be a promising therapy for GVHD, as reported in a few reports with a small number of patients [5][6][7][8]. Its mechanism of action seems to be related to suppression of the proinflammatory signaling that mediates tissue damage and by the promotion of tolerogenic regulatory T (T-reg) cells [9].…”

mentioning

confidence: 99%

“…Hurabielle et al [7] recently reported the use of ruxolitinib in 12 patients with severe sclerodermatous cGVHD. The drug led to a partial improvement in skin softness in the majority of the cases (8/12; 75%).…”

mentioning

confidence: 99%

Ruxolitinib in steroid-refractory chronic graft-versus-host disease: experience of a single center

Ferreira

Silva

Pereira

et al. 2018

Bone Marrow Transplant

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“…Ruxolitinib, also named Jakafi, is a novel and effective drug with anti‐inflammatory properties, demonstrated for treatment of both acute and chronic GVHD (Spoerl et al , ). Many clinical trials have proven their promising outcomes (Zeiser et al , ; Hurabielle et al , ). As a selective Janus kinase (JAK) 1/2 inhibitor, ruxolitinib blocks T cell activation and survival, while also influencing the differentiation and mutation of dendritic cells (Bendstrup et al , ).…”

Section: Discussionmentioning

confidence: 99%

Developing role of B cells in the pathogenesis and treatment of chronic GVHD

Gao

Feng

et al. 2018

Br J Haematol

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Summary Chronic graft‐versus‐host disease (cGVHD) is a major complication affecting the long‐term survival of patients after allogeneic haematopoietic stem cell transplantation. The mechanism of cGVHD is unclear, and while previous studies have primarily focused on T cells, the role of B cells in the pathogenesis of cGVHD has been less reported. However, current studies on cGVHD are increasingly focused on the important role of B cells. In this review, we will introduce the newest studies and examine the role of B cells in cGVHD in detail with respect to the following aspects: altered B cell subpopulations, aberrant B cell signalling pathways, autoantibodies and T‐B cell interactions. Treatment strategies for the targeting of B cells during cGVHD will also be discussed.

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Efficacy and tolerance of ruxolitinib in refractory sclerodermatous chronic graft‐versus‐host disease

Cited by 26 publications

References 8 publications

Ruxolitinib in refractory acute and chronic graft-versus-host disease: a multicenter survey study

Ruxolitinib in refractory acute and chronic graft-versus-host disease: a multicenter survey study

Ruxolitinib in steroid-refractory chronic graft-versus-host disease: experience of a single center

Developing role of B cells in the pathogenesis and treatment of chronic GVHD

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