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• W2247181142 abstract "6672 Background Steroid refractory aGVHD has a poor prognosis of <10% 1 yr. This is a retrospective analysis to evaluate the clinical efficacy of Dac in pts with steroid refractory aGVHD defined as failure to respond to MPSE (methylprednisone) at 2mg/kg for 7 days or worsening symptoms after 72 hours. Methods 68 pts underwent allogeneic transplantation between 3/00 and 12/03 were reviewed. Sib 13, MUD 37. Conditioning regimen reduced intensity n=27 fully ablative n=41. 39 men and 29 women median age 46.9 (1.0–67.3). Diagnoses AML n=17, ALL n=13, CML n=10, NHL n=6, HD n=1, MDS n=8, other n=13. All pts received standard CSA or FK506 based GVHD prophylaxis. Pts progressing on Dac received additional GVHD therapy. Results Median time from tx to start of Dac was 49.0 d (19–141) and onset of aGVHD to start of Dac was 14.5 d (1–110). At the start of Dac, GVHD was grade II n=6, grade III n=30, grade IV n=32. At d 100, 4/6 (66.7%) grade II, 21/30 (70%) grade III, 19/32 (59.4%) grade IV were the same or worse. Initiating Dac within 2 wks of the onset of aGVHD did not significantly impact the grade at d 100. Overall survival was 12.3% at 1 yr. 34 pts died within 100 days. GVHD was a primary or contributing cause of death in 66% of the pts. The number of pts with improved grade GVHD at d 100 had better survival as compared to the nonresponding pts p<.01 with a 100 d survival of 84% and a 1 yr survival of 29%. chGVHD developed in 64.7% of the pts that survived beyond d 100. There was no association between the timing of Dac use and the incidence of chGVHD when a 50 d cutoff was used. Effect of Dac on steroid use All pts were on high doses of steroids(>80) mg per d for a median of 8.0 (0–64) days prior to the start of Dac. After the start of Dac steroids had to be increased further in 5 pts, decreased in 26 pts and remained unchanged in 36. There was no significant steroid sparing effect of the use of Dac in the setting of aGVHD. Conclusion This is a large retrospective experience of use of Dac in the setting of steroid refractory aGVHD showing no significant benefit. This confirms the experience reported by other centers. There continues to be a need to find effective treatments for steroid refractory aGVHD. No significant financial relationships to disclose." @default.
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• W2247181142 date "2005-06-01" @default.
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• W2247181142 title "The use of daclizumab for treatment of steroid refractory acute GVHD. A City of Hope experience" @default.
• W2247181142 doi "https://doi.org/10.1200/jco.2005.23.16_suppl.6672" @default.
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