Sclerodermatous Chronic Graft-versus-Host Disease Treated With Imatinib: A Dermatological Perspective.
ACTAS DERMO-SIFILIOGRAFICAS 2017;
109:241-247. [PMID:
29254596 DOI:
10.1016/j.ad.2017.11.003]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/12/2017] [Accepted: 11/05/2017] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION
Chronic graft-versus-host disease (cGVHD) is the most important cause of late non-relapse mortality after allogeneic hematopoietic stem cell transplantation. Sclerodermatous cGVHD is usually steroid refractory and remains a therapeutic challenge. Activating antibodies against the PDGFR have been reported in patients with sclerodermatous cGVHD. These antibodies induce PDGFR phosphorylation and lead to fibrosis. There is increasing evidence of successful treatment of sclerodermatous cGVHD with imatinib, a tyrosine kinase inhibitor.
OBJECTIVE
To evaluate the response of cutaneous sclerodermatous cGVHD to imatinib.
MATERIALS AND METHODS
Retrospective study of 18 patients with sclerodermatous cGVHD refractory to immunosuppressants treated with imatinib in a single center. Evaluation of treatment response was performed by clinicians' assessment and patients' subjective response at one, 3, 6, 9, 12 and 18 months after initiation of imatinib. Response was assessed as complete, partial, significant, no change or progression. Tapper off steroids was complete, partial or not possible.
RESULTS
In our series, 4 (22%) patients achieved complete response, 9 (50%) patients partial response, 2 (11%) patients significant response, 2 (11%) patients had no change and one (6%) patient progressive disease at last follow-up. Mean time from initiation of imatinib to any degree of response was 2,75 months (range 1-9 months).
CONCLUSIONS
This study provides further evidence of the role of imatinib for the treatment of steroid refractory sclerodermatous cGVHD.
Collapse