Original scientific paper

https://doi.org/10.3325/cmj.2016.57.247

Imatinib and dasatinib as salvage therapy for sclerotic chronic graft-vs-host disease

Isabel Sánchez-Ortega ; Department of Clinical Hematology, Catalan Institute ofOncology, Hospital Duran i Reynals,Barcelona, Spain
Rocío Parody ; Department of Clinical Hematology, Catalan Institute ofOncology, Hospital Duran i Reynals,Barcelona, Spain
Octavio Servitje ; Department of Dermatology Hospital Universitari de Bellvitge Barcelona, Spain
Cristina Muniesa ; Department of Dermatology Hospital Universitari de Bellvitge Barcelona, Spain
Montserrat Arnan ; Department of Clinical Hematology, Catalan Institute ofOncology, Hospital Duran i Reynals,Barcelona, Spain
Beatriz Patińo ; Department of Clinical Hematology, Catalan Institute ofOncology, Hospital Duran i Reynals,Barcelona, Spain
Anna Sureda ; Department of Clinical Hematology, Catalan Institute ofOncology, Hospital Duran i Reynals,Barcelona, Spain
Rafael F. Duarte ; Department of Clinical Hematology, Hospital Universitario Puerta de Hierro, Madrid, Spain

Abstract

Aim To assess the toxicity, tolerance, steroid-sparing capacity,
effectiveness, and response rate to imatinib and dasatinib
for the treatment of severe sclerotic chronic graftvs-
host disease (scGVHD).
Methods This retrospective study analyzed 8 consecutive
patients with severe refractory scGVHD who received salvage
therapy with imatinib. Patients intolerant and/or refractory
to imatinib received dasatinib treatment.
Results 7 patients discontinued imatinib treatment (1
achieved complete response, 5 were resistant and/or intolerant,
and 1 developed grade IV neutropenia) and 1 patient
achieved prolonged partial response, but died due to
an infectious complication while on treatment. 5 patients
started dasatinib treatment (3 achieved partial responses
and discontinued dasatinib, 1 achieved a durable partial
response, but died due to a consecutive rapid pulmonary
cGVHD progression and 1 with stable disease discontinued
treatment due to gastroenteric intolerance). The response
rate (partial and/or complete responses) for severe scGVHD
was 25% for imatinib and 60% for dasatinib.
Conclusion In our series, dasatinib was better tolerated,
safer, steroid-sparing, and had a low incidence of infectious
complications, which suggests that it may be a more effective
therapeutic alternative for patients with refractory
scGVHD than imatinib. Treatment of scGVHD with effective
antifibrotic drugs such as TKI, which block the kinase fibrotic
pathway, may be a safe and effective therapeutic option,
but further studies are needed to confirm our findings.

Keywords

Hrčak ID:

169615

URI

https://hrcak.srce.hr/169615

Publication date:

15.6.2016.

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