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Alefacept treatment for refractory chronic extensive GVHD
M Y Shapira1, A Abdul-Hai, I B Resnick
1Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Bone Marrow Transplantation
|October 14, 2008
Summary
Alefacept effectively treats chronic graft-versus-host disease (cGVHD), improving outcomes in most patients. Further research is needed to optimize alefacept dosage and treatment intervals for cGVHD management.
Area of Science:
- Immunology
- Hematology
- Dermatology
Background:
- Alefacept, an immunosuppressive fusion protein, is approved for psoriasis.
- Previous studies indicated alefacept's efficacy in acute steroid-resistant/dependent graft-versus-host disease (GVHD).
- Chronic extensive GVHD (cGVHD) remains a significant challenge post-transplantation.
Purpose of the Study:
- To evaluate the efficacy and safety of alefacept in patients with chronic extensive GVHD.
- To assess treatment response, duration, and overall survival in cGVHD patients receiving alefacept.
Main Methods:
- A cohort of twelve patients with cGVHD received alefacept treatment.
- Response was assessed based on marked, moderate, or minimal improvement.
- Patient outcomes, including survival and complications, were monitored over a median follow-up of 30 months.
Main Results:
- Eight out of twelve patients (67%) showed a response to alefacept treatment.
- The median time to initial response was 2.25 weeks.
- Long-term follow-up showed 6 of 12 patients alive with stable or improved cGVHD; no transplant relapses occurred. Alefacept treatment increased the percentage of naive T cells.
Conclusions:
- Alefacept demonstrates effectiveness in treating chronic extensive GVHD.
- Further investigation into optimal alefacept dosing and treatment schedules is warranted.
- Alefacept may represent a valuable therapeutic option for managing cGVHD.
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