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Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Biol+Blood+Marrow+Transplant 2015 ; 21 (6): 1083-90 Nephropedia Template TP
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Imatinib mesylate for the treatment of steroid-refractory sclerotic-type cutaneous chronic graft-versus-host disease #MMPMID25771402
Baird K; Comis LE; Joe GO; Steinberg SM; Hakim FT; Rose JJ; Mitchell SA; Pavletic SZ; Figg WD; Yao L; Flanders KC; Takebe N; Sarantopoulos S; Booher S; Cowen EW
Biol Blood Marrow Transplant 2015[Jun]; 21 (6): 1083-90 PMID25771402show ga
Sclerotic skin manifestations of chronic graft-versus-host disease (ScGVHD) lead to significant morbidity, including functional disability from joint range of motion (ROM) restriction. No superior second-line therapy has been established for steroid-refractory disease. Imatinib mesylate is a multi-kinase inhibitor of several signaling pathways implicated in skin fibrosis with in vitro antifibrotic activity. We performed an open label pilot Phase 2 trial of imatinib in children and adults with corticosteroid refractory ScGVHD. Twenty patients were enrolled in a 6 month trial. Eight received a standard dose (adult: 400 mg daily; children: 260 mg/m2 daily). Due to poor tolerability, 12 additional patients underwent a dose escalation regimen (adult: 100 mg daily initial dose up to 200 mg daily maximum; children initial dose 65 mg/m2 daily up to 130 mg/m2 daily). Fourteen patients were evaluable for primary response, improvement in joint range of motion (ROM) deficit, at 6 months. Primary outcome criteria for partial response (PR) was met in 5/14 (36%), stable disease (SD) in 7/14 (50%), and progressive disease (PD) in 2/14 (14%) patients. Eleven (79%) patients, including 5 PR and 6 with SD, demonstrated a positive gain in ROM (range 3?94% improvement in deficit). Of 13 patients with measurable changes at 6 months, the average improvement in ROM deficit was 24.2% (IQR: 15.5% to 30.5%; p=0.011).This trial is registered at http://clinicaltrials.gov as NCT007020689.