Impact of cytopenias and early versus late treatment with ruxolitinib in patients with steroid-refractory acute or chronic graft-versus-host disease
Abstract: REACH2 and REACH3 were randomized, multicenter, open-label phase 3 studies comparing the selective Janus kinase (JAK)1/JAK2 inhibitor ruxolitinib versus investigators’ choice of best available therapy (BAT) in steroid-refractory (SR) acute (REACH2) or chronic (REACH3) graft-versus-host disease (aGVHD/cGVHD). Moderate-severe aGVHD/cGVHD can progress rapidly; thus, key clinical considerations driving management of patients with SR-aGVHD/SR-cGVHD are prompt treatment initiation and concomitant cytopenias. These post hoc analyses of REACH2/REACH3 describe the impact of timing of treatment initiation after SR-aGVHD/SR-cGVHD diagnosis and development of concomitant cytopenias on treatment outcomes. Ruxolitinib initiation within 3 days from SR-aGVHD diagnosis yielded an extended duration of response and higher Day 28 complete response rates compared with initiation ≥7 days after SR-aGVHD diagnosis (median 178 vs 167 days and 36.6% vs 25.0%, respectively). For patients with SR-cGVHD, Week 24 overall response was not impacted by time to treatment (54.5% vs 42.6% for <14 vs >28 days). Clinically relevant cytopenias were manageable, allowing for maintenance of dose intensity (median 20 mg/d), and did not impact the favorable efficacy outcomes from ruxolitinib treatment. This analysis highlights the practical importance of considering earlier ruxolitinib initiation after SR diagnosis in GVHD and the benefits of ruxolitinib treatment compared with BAT even for patients with cytopenias
- Location
-
Deutsche Nationalbibliothek Frankfurt am Main
- Extent
-
Online-Ressource
- Language
-
Englisch
- Notes
-
Bone marrow transplantation. - 60, 1 (2025) , 69-78, ISSN: 1476-5365
- Event
-
Veröffentlichung
- (where)
-
Freiburg
- (who)
-
Universität
- (when)
-
2024
- Creator
-
Mahmoudjafari, Zahra
Bhatt, Valkal
Galvin, John
Xue, Zhenyi
Zeiser, Robert
Locatelli, Franco
Socié, Gerard
Mohty, Mohamad
- DOI
-
10.1038/s41409-024-02445-6
- URN
-
urn:nbn:de:bsz:25-freidok-2608842
- Rights
-
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
- Last update
-
15.08.2025, 7:21 AM CEST
Data provider
Deutsche Nationalbibliothek. If you have any questions about the object, please contact the data provider.
Associated
- Mahmoudjafari, Zahra
- Bhatt, Valkal
- Galvin, John
- Xue, Zhenyi
- Zeiser, Robert
- Locatelli, Franco
- Socié, Gerard
- Mohty, Mohamad
- Universität
Time of origin
- 2024
Other Objects (12)
Advances in understanding the pathogenesis of graft‐versus‐host disease
Immunomodulatory therapies for the treatment of graft-versus-host disease
Kinase inhibition as treatment for acute and chronic graft-versus-host disease
The role of purine metabolites as DAMPs in acute graft-versus-host disease
The role of MicroRNAs in myeloid cells during graft-versus-host disease
Die Rolle von extrazellulärem ATP bei der Entstehung der akuten Graft-©versus-©Host Erkrankung
Acute graft-versus-host disease, infections, vascular events and drug toxicities affecting the central nervous system
Deciphering the role of the major histocompatibility complex, the intestinal microbiome and metabolites in the pathogenesis of acute graft-versus-host disease
Editorial on translational research in graft-versus-host disease (GVHD) and graft-versus-tumor (GVT) effect after allogeneic hematopoietic cell transplantation
Modulation of gastrointestinal graft-versus-host disease via the Enteroenedocrine glucagon-like peptide 2 (GLP-2)
Extracorporeal photopheresis in acute and chronic steroid‑refractory graft-versus-host disease: an evolving treatment landscape
Interfering with inflammation: heterogeneous effects of interferons in graft-versus-host disease of the gastrointestinal tract and inflammatory bowel disease
Advances in understanding the pathogenesis of graft‐versus‐host disease
Immunomodulatory therapies for the treatment of graft-versus-host disease
Kinase inhibition as treatment for acute and chronic graft-versus-host disease
The role of purine metabolites as DAMPs in acute graft-versus-host disease
The role of MicroRNAs in myeloid cells during graft-versus-host disease
Die Rolle von extrazellulärem ATP bei der Entstehung der akuten Graft-©versus-©Host Erkrankung
Acute graft-versus-host disease, infections, vascular events and drug toxicities affecting the central nervous system
Deciphering the role of the major histocompatibility complex, the intestinal microbiome and metabolites in the pathogenesis of acute graft-versus-host disease
Editorial on translational research in graft-versus-host disease (GVHD) and graft-versus-tumor (GVT) effect after allogeneic hematopoietic cell transplantation
Modulation of gastrointestinal graft-versus-host disease via the Enteroenedocrine glucagon-like peptide 2 (GLP-2)
Extracorporeal photopheresis in acute and chronic steroid‑refractory graft-versus-host disease: an evolving treatment landscape
Interfering with inflammation: heterogeneous effects of interferons in graft-versus-host disease of the gastrointestinal tract and inflammatory bowel disease
Advances in understanding the pathogenesis of graft‐versus‐host disease
Immunomodulatory therapies for the treatment of graft-versus-host disease
Kinase inhibition as treatment for acute and chronic graft-versus-host disease
The role of purine metabolites as DAMPs in acute graft-versus-host disease
The role of MicroRNAs in myeloid cells during graft-versus-host disease
Die Rolle von extrazellulärem ATP bei der Entstehung der akuten Graft-©versus-©Host Erkrankung
Acute graft-versus-host disease, infections, vascular events and drug toxicities affecting the central nervous system
Deciphering the role of the major histocompatibility complex, the intestinal microbiome and metabolites in the pathogenesis of acute graft-versus-host disease
Editorial on translational research in graft-versus-host disease (GVHD) and graft-versus-tumor (GVT) effect after allogeneic hematopoietic cell transplantation
Modulation of gastrointestinal graft-versus-host disease via the Enteroenedocrine glucagon-like peptide 2 (GLP-2)
Extracorporeal photopheresis in acute and chronic steroid‑refractory graft-versus-host disease: an evolving treatment landscape