Efficacy and safety of ruxolitinib plus extracorporeal photopheresis in acute and chronic graft versus host disease: A single center experience

Authors

  • Ahmet Sarici Department of Adult Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Mehmet Ali Erkurt Department of Adult Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Omer Faruk Bahcecioglu Department of Clinical Pharmacy, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Lokman Hekim Tanriverdi Department of Medical Pharmacology, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Ilhami Berber Department of Adult Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Emin Kaya Department of Adult Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Soykan Bicim Department of Adult Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Selim Gok Department of Clinical Pharmacy, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Mustafa Ozgul Department of Adult Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Irfan Kuku Department of Adult Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey

Keywords:

Allogeneic transplantation, corticosteroids, extracorporeal photopheresis, graft-versus host disease, ruxolitinib

Abstract

Aim: There is no standard treatment for corticosteroid refractory acute and chronic graft versus host disease (GVHD). Ruxolitinib and extracorporeal phopheresis (ECP) are promising treatment options in GVHD. In this study, we aimed to share our clinical experience in steroid refractory GVHD patients treated with ruxolitinib plus ECP.
Materials and Methods: The data of patients receiving ruxolitinib plus ECP for corticosteroid refractory acute and chronic GVHD patients were analyzed retrospectively.
Results: A total of 11 cases, 6 of which were acute, were included in this retrospective, observational and single-center study. Acute GVHD developed in the 6 patients after allogeneic HSCT (median onset of GVHD=27, between 20 and 60 days ). Chronic GVHD developed in the 5 patients after allogeneic HSCT (median onset of GVHD= 159 between 60 and 380 days. The overall response rate of acute GVHD patients to ruxolitinib ECP combination therapy was 16.7% (complete response: 16.7%, partial response: 0%). The overall response rate of chronic GVHD patients to combination therapy was 60% (complete response: 20%, partial response: 40%). As a result of combination therapy, thrombocytopenia occurred in 36% (4/11) of patients, neutropenia in 27% (3/11) of patients, and CMV reactivation in 9% (1/11) of patients.
Conclusion: We observed a low rate of overall response to ruxolitinib plus ECP treatment in acute GVHD patients but a high rate in chronic GVHD patients. According to our trial, ruxolitinib ECP combination may be beneficial in GVHD, especially in chronic GVHD, but prospective trials comparing its efficacy with other agents are needed.

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Published

2021-11-24

How to Cite

Sarici, A., Erkurt, M. A., Bahcecioglu, O. F., Tanriverdi, L. H., Berber, I., Kaya, E., Bicim, S., Gok, S., Ozgul, M., & Kuku, I. (2021). Efficacy and safety of ruxolitinib plus extracorporeal photopheresis in acute and chronic graft versus host disease: A single center experience. Annals of Medical Research, 28(11), 2065–2070. Retrieved from https://annalsmedres.org/index.php/aomr/article/view/3977

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