Page 182 - Haematologica-April 2018
P. 182

W.R. Drobyski et al.
A B
CD
EF
Figure 6. GvHD and transplant outcomes in patients treated with tocilizumab versus a matched CIBMTR control popu- lation. (A). Cumulative inci- dence of grades II-IV aGvHD in patients treated with tocilizum- ab versus the matched control cohort. (B). Probability of grades II-IV aGvHD-free survival. (C). Cumulative incidence of cGvHD, (D) transplant-related mortality, and (E) relapse. (F) Probability of disease-free survival in patients treated with tocilizum- ab versus the matched control cohort. Toc: tocilizumab: Tac: tacrolimus; MTX: methotrexate.
matched control population. There was, however, no dif- ference in the incidence of cGvHD or a reduction in TRM. We conclude that Toc has activity for the prevention of aGvHD, and warrants further examination in a random- ized setting.
Funding
This research was supported by a grant from the Kurtis Froedtert Foundation at the Medical College of Wisconsin Cancer Center.
726
discernible adverse effect on immune reconstitution, as patients achieved near normal T-cell and B-cell subset numbers by 6-12 months post-transplantation.
In summary, this study demonstrates that Toc can be safely administered in conjunction with standard immune suppression to an older aged patient cohort treated with a Bu-based conditioning for the prevention of GvHD. The administration of Toc resulted in a low incidence of aGvHD, which was particularly evident within the lower GI tract, and was significantly less than that observed in a
References
1. Ferrara JLM, Levine JE, Reddy P, Holler E. Graft-versus-host-disease. Lancet. 2009; 373(9674):1550-1561.
2. Welniak LA, Blazar BR, Murphy WJ. Immunobiology of allogeneic hematopoi- etic stem cell transplantation. Ann Rev Immunol. 2007;25:139-170.
3. Shlomchik WD. Graft-versus-host disease. Nat Rev Immunol. 2007;7(5):340-352.
4. Tvedt THA, Ersvaer E, Tveita AA, Bruserud O. Interleukin 6 in allogeneic stem cell transplantation: Its possible importance for immunoregulation and as a
therapeutic target. Front Immunol.
2017;8:667.
5. Toubai T, Mathewson ND, Magenau J,
Reddy P. Danger signals and graft versus host disease: Current understanding and future perspective. Front Imunol. 2016;7:539.
6. Choi SW, Reddy P. Current and emerging strategies for the prevention of graft versus host disease. Nat Rev Clin Oncol. 2014;11(9):536-547.
7. Chen X, Das R, Komorowski R, et al. Blockade of interleukin 6 signaling aug- ments regulatory T cell reconstitution and attenuates the severity of graft versus host disease. Blood. 2009;114(4):891-900.
8. Tawara I, Koyama M, Liu C, et al. Interleukin 6 modulates graft versus host responses after experimental allogeneic bone marrow transplantation. Clin Can Res. 2011;17(1):77-88.
9. Barak V, Levi-Schaffer F, Nisman B, Nagler A. Cytokine dysregulation in chronic graft versus host disease. Leuk Lymphoma. 1995;17(1-2):169-173.
10. Imamura M, Hashino S, Kobayashi H, et al. Serum cytokine levels in bone marrow transplantation: synergistic interaction of interleukin 6, interferon gamma, and tumor necrosis factor alpha in graft versus host disease. Bone Marrow Transplant. 1994;13(6):745-751.
haematologica | 2018; 103(4)


































































































   180   181   182   183   184