Motlló Cristina, Ferrà Christelle, López Laia, Morgades Mireia, Batlle Montserrat, Ribera Josep Maria
Servicio de Hematología Clínica, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Badalona, Institut de Recerca Contra la Leucèmia Josep Carreras, Universidad Autónoma de Barcelona, Barcelona, España.
Med Clin (Barc). 2011 Jun 25;137(3):115-8. doi: 10.1016/j.medcli.2011.03.006. Epub 2011 May 4.
Severe acute graft versus host disease (GVHD) and extensive chronic GVHD not responding to steroids have poor prognosis. Infliximab has reported to be effective in some of these patients. The efficacy of infliximab for the treatment of patients with steroid-resistant GVHD was evaluated.
Retrospective analysis to evaluate the activity and toxicity of infliximab in 9 patients with acute or chronic steroid resistant GVHD.
Six patients had acute GVHD and 3 chronic GVHD. The source of progenitors was peripheral blood in all patients except one. Six received matched-related SCT and 3 unrelated SCT. Patients received between 2 and 7 doses of infliximab, and 5 achieved a partial response. All patients presented infections: 4 developed Pseudomonas aeruginosa septicemia and 5 probable or confirmed infection by Aspergillus fumigatus.
Infliximab provides transient response in steroid-resistant GVHD. However, it is associated with a high rate of infections. Earlier administration of infliximab should be explored to reduce the frequency of infections.
严重急性移植物抗宿主病（GVHD）以及对类固醇治疗无反应的广泛性慢性GVHD预后较差。据报道，英夫利昔单抗对其中部分患者有效。本研究评估了英夫利昔单抗治疗类固醇抵抗型GVHD患者的疗效。
对9例急性或慢性类固醇抵抗型GVHD患者进行回顾性分析，以评估英夫利昔单抗的活性和毒性。
6例为急性GVHD，3例为慢性GVHD。除1例患者外，所有患者的祖细胞来源均为外周血。6例接受了匹配相关的造血干细胞移植（SCT），3例接受了无关供者SCT。患者接受了2至7剂英夫利昔单抗治疗，5例获得部分缓解。所有患者均出现感染：4例发生铜绿假单胞菌败血症，5例可能或确诊为烟曲霉感染。
英夫利昔单抗可使类固醇抵抗型GVHD获得短暂缓解。然而，其与高感染率相关。应探索更早使用英夫利昔单抗以降低感染频率。
