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Ruxolitinib treatment for SR-aGVHD in patients with EBV-HLH undergoing allo-HSCT.
Annals of Hematology ( IF 3.5 ) Pub Date : 2019-12-26 , DOI: 10.1007/s00277-019-03864-y
Guangqiang Meng 1 , Jingshi Wang 1 , Xinkai Wang 1 , Yini Wang 1 , Zhao Wang 1
Affiliation  

Ruxolitinib is a promising option for treating steroid-refractory acute graft-versus-host disease (SR-aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In this study, we describe ruxolitinib treatment for SR-aGVHD in HSCT patients with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) to evaluate its effectiveness. We evaluated the outcomes of 12 patients who received ruxolitinib for SR-aGVHD between January 2017 and March 2019. Of the 12 patients who received ruxolitinib, 7 patients achieved a complete response (CR), 3 had a partial response (PR), and 2 experienced treatment failure (TF). OS and CR rates were 83.3% and 58.3%, respectively. Moreover, CR was achieved by the six patients who had aGVHD with skin involvement. The mean time of steroid application in the patients who received ruxolitinib was 28.1 days. Median survival after HSCT was 64.6 weeks. The adverse effects of ruxolitinib included grades 3 to 4 neutropenia (n = 7) and grades 3 to 4 thrombocytopenia (n = 6). Cytomegalovirus reactivation was observed in three patients. A high rate of CR and short steroid application time of ruxolitinib as a salvage treatment were observed in HSCT patients with EBV-HLH. Consequently, from this study, it was determined that ruxolitinib is an optimal choice to treat SR-aGVHD in patients with EBV-HLH.

中文翻译:

Ruxolitinib 治疗接受 allo-HSCT 的 EBV-HLH 患者的 SR-aGVHD。

Ruxolitinib 是治疗同种异体造血干细胞移植 (allo-HSCT) 后类固醇难治性急性移植物抗宿主病 (SR-aGVHD) 的有希望的选择。在这项研究中,我们描述了 ruxolitinib 治疗患有 Epstein-Barr 病毒相关噬血细胞淋巴组织细胞增生症 (EBV-HLH) 的 HSCT 患者的 SR-aGVHD,以评估其有效性。我们评估了 2017 年 1 月至 2019 年 3 月期间接受鲁索替尼治疗 SR-aGVHD 的 12 名患者的结局。在接受鲁索替尼治疗的 12 名患者中,7 名患者达到完全缓解 (CR),3 名患者获得部分缓解 (PR),2 名患者经历过治疗失败(TF)。OS 和 CR 率分别为 83.3% 和 58.3%。此外,6 名患有 aGVHD 且皮肤受累的患者实现了 CR。接受鲁索替尼治疗的患者中类固醇应用的平均时间为 28.1 天。HSCT 后的中位生存期为 64.6 周。鲁索替尼的不良反应包括 3 至 4 级中性粒细胞减少症(n = 7)和 3 至 4 级血小板减少症(n = 6)。在三名患者中观察到巨细胞病毒再激活。在 EBV-HLH 的 HSCT 患者中观察到鲁索替尼作为挽救治疗的高 CR 率和较短的类固醇应用时间。因此,本研究确定鲁索替尼是治疗 EBV-HLH 患者 SR-aGVHD 的最佳选择。在 EBV-HLH 的 HSCT 患者中观察到鲁索替尼作为挽救治疗的高 CR 率和较短的类固醇应用时间。因此,本研究确定鲁索替尼是治疗 EBV-HLH 患者 SR-aGVHD 的最佳选择。在 EBV-HLH 的 HSCT 患者中观察到鲁索替尼作为挽救治疗的高 CR 率和较短的类固醇应用时间。因此,本研究确定鲁索替尼是治疗 EBV-HLH 患者 SR-aGVHD 的最佳选择。
更新日期:2020-01-04
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