Efficacy of anti-CD25 monoclonal antibody used in treating steroid-resistant acute graft-versus-host disease following haploidentical bone marrow transplantation / 中国实验血液学杂志

ABSTRACT

The aim of this study was to investigate the efficacy and feasibility of anti-CD25 monoclonal antibody (basiliximab) in treating steroid-refractory acute graft-versus-host disease (aGVHD) following haploidentical bone marrow transplantation (hiBMT). 15 cases who developed II-IV grade steroid-resistant aGVHD after haploidentical BMT were treated by intravenous injection of basiliximab at a dose of 20 mg on days 1 and 4. In those patients not achieving CR after 1 week, basiliximab injection was repeated. The results showed that 8 cases (53.33%) got complete response (CR). Out of them 4 cases have been still in disease-free survival, 2 cases have been in survival with limited cGVHD, 2 cases died from pulmonary infection; 3 cases (65%) got partial response (PR), out of whom 1 case has been still in disease-free survival, one died from GVHD and infection, and another one died from pulmonary infection; 4 cases without response died from GVHD, pulmonary infection and cardiac failure. Overall response rate was 73.3% and long-term survival rate was 46. 7%. There were no infusion-associated side-effects after treatment with basiliximab. It is concluded that the anti-CD25 monoclonal antibody is efficacious and feasible for steroid-refractory grade II-IV aGVHD after hiBMT, but the overall survival rate is low. Infection is the main cause of death. Thereby, it is especially important to strengthen environmental protection and prevent infection.