Patient characteristics, GVHD features, and response to imatinib (N = 39)
. | Values . |
---|---|
Sex ratio, male/female, n | 31/8 |
Mean age, y (range) | 42 (5-70) |
Diagnosis, n | |
AML/ALL | 10/8 |
MM/CML | 7/4 |
Other MPS/MDS | 3/2 |
HD/NHL | 2/3 |
Type of transplantation, sibling/MUD, n | 23/16 |
Stem cell source, PBSC/BM, n | 32/7 |
Conditioning, MA/NMA/RIC, n | 27/1/11 |
GVHD prophylaxis, n | |
MTX + CsA/MMF + CsA/CsA | 27/11/1 |
Acute GVHD target organs, n | |
Skin/gut/both/none | 26/5/6/2 |
cGVHD target sites, n (%) | |
Skin (fibrotic features) | 39 (100) |
Eye and/or mouth mucosa | 32 (82) |
Lung (bronchiolitis obliterans) | 18 (46) |
Liver | 9 (23) |
Digestive tract | 6 (15) |
2 or more target sites | 25 (64) |
cGVHD skin scoring, n (%) | |
Grade 3 (> 50% BSA OR deep sclerotic features OR ulcerations OR inability to move) | 33 (85) |
Grade 2 (< 50% BSA and/or superficial sclerotic features only) | 6 (15) |
Previous treatments for cGVHD, n (%) | |
Systemic corticosteroids | 39 (100) |
MMF | 30 (77) |
CsA | 24 (62) |
ECP | 14 (36) |
RTX/rapamycin/evero/thali/MTX/AZA/pento | 7/6/2/2/1/1/1 |
PUVA/TAI/TLI | 4/3/1 |
2 or more previous treatments for cGVHD | 37 (95) |
Mean time from cGVHD to imatinib start, mo (SD) | 29 (28) |
Imatinib maximal daily posology, mg, n | |
100/200/300/400/600 | 9/8/9/13/1 |
Mean IM treatment duration, mo (SD) | 13 (10) |
Concomitant treatments for cGVHD, n (%) | |
Systemic corticosteroids | 33 (85) |
MMF | 15 (38) |
CsA | 12 (31) |
ECP | 6 (15) |
Rapamycin | 3 (8) |
2 or more concomitant treatments | 25 (64) |
Physician global assessment of skin cGVHD evolution after imatinib start, n (%)* | |
Complete remission | 1 (2) |
Improvement | 9 (23) |
Improvement, then relapse | 2 (5) |
Stability | 12 (31) |
Worsening | 15 (39) |
Overall improvement of skin cGVHD after IM start, n (%) | 12 (31) |
Corticosteroids tapered, n (%) | 9 (23) |
Improvement of skin cGVHD, n | 3 |
Stability of skin cGVHD, n | 5 |
Worsening of skin cGVHD, n | 1 |
Corticosteroids discontinued, n (%) | 7 (18) |
Improvement of skin cGVHD, n | 6 |
Stability of skin cGVHD, n | 1 |
Grade 3 or 4 adverse events (WHO), n (%) | 12 (31) |
Cytopenias | 3 (8) |
Generalized fluid retention | 7 (18) |
Impaired consciousness | 2 (5) |
Outcome at the last follow-up, dead/alive, n | 6/33 |
Mean follow-up after imatinib start, mo (SD) | 18 (12) |
. | Values . |
---|---|
Sex ratio, male/female, n | 31/8 |
Mean age, y (range) | 42 (5-70) |
Diagnosis, n | |
AML/ALL | 10/8 |
MM/CML | 7/4 |
Other MPS/MDS | 3/2 |
HD/NHL | 2/3 |
Type of transplantation, sibling/MUD, n | 23/16 |
Stem cell source, PBSC/BM, n | 32/7 |
Conditioning, MA/NMA/RIC, n | 27/1/11 |
GVHD prophylaxis, n | |
MTX + CsA/MMF + CsA/CsA | 27/11/1 |
Acute GVHD target organs, n | |
Skin/gut/both/none | 26/5/6/2 |
cGVHD target sites, n (%) | |
Skin (fibrotic features) | 39 (100) |
Eye and/or mouth mucosa | 32 (82) |
Lung (bronchiolitis obliterans) | 18 (46) |
Liver | 9 (23) |
Digestive tract | 6 (15) |
2 or more target sites | 25 (64) |
cGVHD skin scoring, n (%) | |
Grade 3 (> 50% BSA OR deep sclerotic features OR ulcerations OR inability to move) | 33 (85) |
Grade 2 (< 50% BSA and/or superficial sclerotic features only) | 6 (15) |
Previous treatments for cGVHD, n (%) | |
Systemic corticosteroids | 39 (100) |
MMF | 30 (77) |
CsA | 24 (62) |
ECP | 14 (36) |
RTX/rapamycin/evero/thali/MTX/AZA/pento | 7/6/2/2/1/1/1 |
PUVA/TAI/TLI | 4/3/1 |
2 or more previous treatments for cGVHD | 37 (95) |
Mean time from cGVHD to imatinib start, mo (SD) | 29 (28) |
Imatinib maximal daily posology, mg, n | |
100/200/300/400/600 | 9/8/9/13/1 |
Mean IM treatment duration, mo (SD) | 13 (10) |
Concomitant treatments for cGVHD, n (%) | |
Systemic corticosteroids | 33 (85) |
MMF | 15 (38) |
CsA | 12 (31) |
ECP | 6 (15) |
Rapamycin | 3 (8) |
2 or more concomitant treatments | 25 (64) |
Physician global assessment of skin cGVHD evolution after imatinib start, n (%)* | |
Complete remission | 1 (2) |
Improvement | 9 (23) |
Improvement, then relapse | 2 (5) |
Stability | 12 (31) |
Worsening | 15 (39) |
Overall improvement of skin cGVHD after IM start, n (%) | 12 (31) |
Corticosteroids tapered, n (%) | 9 (23) |
Improvement of skin cGVHD, n | 3 |
Stability of skin cGVHD, n | 5 |
Worsening of skin cGVHD, n | 1 |
Corticosteroids discontinued, n (%) | 7 (18) |
Improvement of skin cGVHD, n | 6 |
Stability of skin cGVHD, n | 1 |
Grade 3 or 4 adverse events (WHO), n (%) | 12 (31) |
Cytopenias | 3 (8) |
Generalized fluid retention | 7 (18) |
Impaired consciousness | 2 (5) |
Outcome at the last follow-up, dead/alive, n | 6/33 |
Mean follow-up after imatinib start, mo (SD) | 18 (12) |
ALL indicates acute lymphoblastic leukemia; AML, acute myeloblastic leukemia; AZA, azathioprin; BSA, body surface area; CML, chronic myelogenous leukemia; CsA, cyclosporin A; ECP, extracorporeal photopheresis; evero, everolimus; HD, Hodgkin disease; MA, myeloablative conditioning; MDS, myelodysplastic syndrome; MM, multiple myeloma; MMF, mycophenolate mofetil; MPS, myeloproliferative syndrome; MTX, methotrexate; MUD, matched unrelated donor; NHL, non-Hodgkin lymphoma; NMA, nonmyeloablative conditioning; PBSCs, peripheral blood stem cells; pento, pentostatin; PUVA, psoralen + UVA therapy; RIC, reduced-intensity conditioning; RTX, rituximab; Sib, sibling; tacro, tacrolimus; TAI, thoracoabominal irradiation; thali, thalidomide; TLI, total lymphoid irradiation; and WHO, World Health Organization.
At the time of imatinib discontinuation or at the last follow-up if imatinib treatment was not discontinued.