Contributions
Abstract: PB1786
Type: Publication Only
Session title: Stem cell transplantation - Clinical
Background
Ruxolitinib (RUX) has been approved for second line treatment of acute graft-versus-host disease (aGVHD). However, the optimal timing for steroid-insensitive aGVHD (SI-aGvHD) remains unclear.
Aims
In this context, our multi-center retrospective study aimed to assess the benefits and risks of initiating RUX treatment for aGvHD poorly responsive to corticosteroid therapy within 7 days (preemptive strategy) compared to that longer than 7 days (salvage strategy).
Methods
The study was a multi-center retrospective study to compare the efficacy and safety profiles of preemptive versus salvage RUX treatment. A total of 49 patients were included, with 32 receiving preemptive RUX within 7 days when fail response to prior steroid and 17 patients treated with salvage RUX longer than 7 days.
Results
The two cohorts were well-matched demographically. Although the baseline condition of aGVHD in both groups were more than half are stage II and mainly with skin involvement, more patients (71.9% vs 35.3%, p==0.015) achieve CR in preemptive cohort which also led to a better survival outcome. The median time to response was shorter in patients treated with preemptive RUX (7 days vs 14 days, p=0.157). The risk of adverse events was comparable between the two groups (SAEs: 25% vs 24%, symptom of Cytopenia:43.8% vs 35.3%, viral reactivation:50% vs 23.5% ). No adverse events led to treatment discontinuation and no viral infections had been documented. The mortality rates were low in 2 cohorts (21.9% vs 23.5%, P=0.582), mainly due to opportunistic infections and aGVHD progression.
Conclusion
It became more common to prompt RUX intervention for patients with SI-GVHD in clinical practice. Consistent with expectations, preemptive strategy was associated with significant better outcomes and rapid improvement in this patient populations. Further prospective trials will be important to confirm the preemptive impact.
Keyword(s): Graft-versus-host disease (GVHD), Ruxolitinib
Abstract: PB1786
Type: Publication Only
Session title: Stem cell transplantation - Clinical
Background
Ruxolitinib (RUX) has been approved for second line treatment of acute graft-versus-host disease (aGVHD). However, the optimal timing for steroid-insensitive aGVHD (SI-aGvHD) remains unclear.
Aims
In this context, our multi-center retrospective study aimed to assess the benefits and risks of initiating RUX treatment for aGvHD poorly responsive to corticosteroid therapy within 7 days (preemptive strategy) compared to that longer than 7 days (salvage strategy).
Methods
The study was a multi-center retrospective study to compare the efficacy and safety profiles of preemptive versus salvage RUX treatment. A total of 49 patients were included, with 32 receiving preemptive RUX within 7 days when fail response to prior steroid and 17 patients treated with salvage RUX longer than 7 days.
Results
The two cohorts were well-matched demographically. Although the baseline condition of aGVHD in both groups were more than half are stage II and mainly with skin involvement, more patients (71.9% vs 35.3%, p==0.015) achieve CR in preemptive cohort which also led to a better survival outcome. The median time to response was shorter in patients treated with preemptive RUX (7 days vs 14 days, p=0.157). The risk of adverse events was comparable between the two groups (SAEs: 25% vs 24%, symptom of Cytopenia:43.8% vs 35.3%, viral reactivation:50% vs 23.5% ). No adverse events led to treatment discontinuation and no viral infections had been documented. The mortality rates were low in 2 cohorts (21.9% vs 23.5%, P=0.582), mainly due to opportunistic infections and aGVHD progression.
Conclusion
It became more common to prompt RUX intervention for patients with SI-GVHD in clinical practice. Consistent with expectations, preemptive strategy was associated with significant better outcomes and rapid improvement in this patient populations. Further prospective trials will be important to confirm the preemptive impact.
Keyword(s): Graft-versus-host disease (GVHD), Ruxolitinib