Daclizumab as useful treatment in refractory acute GVHD: a paediatric experience

• Published in: Bone marrow transplantation (Basingstoke) Vol. 43; no. 5; pp. 423 - 427
• Main Authors: MIANO, M, CUZZUBBO, D, TERRANOVA, P, GIARDINO, S, LANINO, E, MORREALE, G, CASTAGNOLA, E, DINI, G, FARACI, M
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.03.2009
• Subjects: Acute Disease; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Biological and medical sciences; Bone marrow; Bone marrow, stem cells transplantation. Graft versus host reaction; Child; Female; Gastrointestinal diseases; Graft vs Host Disease - drug therapy; Graft-versus-host reaction; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Immunoglobulin G - therapeutic use; Immunosuppressive Agents - therapeutic use; Male; Medical sciences; Patients; Pediatrics; Stem cell transplantation; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Homologous; Human; Immunopathology; Graft versus host disease; Treatment resistance; acute GVHD; Hematology; SCT; Acute; Stem cell; Hematopoietic cell; Monoclonal antibody; Daclizumab; Immunomodulator; Treatment; children; Immunosuppressive agent; Child
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2008.331

GVHD remains a serious complication after allogeneic SCT. We describe 13 paediatric patients treated with daclizumab for refractory acute GVHD (aGVHD). After 30 days of daclizumab administration, all patients with cutaneous aGVHD reached complete response. Among patients with gastrointestinal disease, 50 and 30% had complete and partial response, respectively, whereas 11 and 55% of patients with hepatic aGVHD achieved CR and PR, respectively. Overall, complete (46%) and partial (46%) responses were demonstrated in 92% of our patients, whereas the remaining patients (8%) were nonresponders. No life-threatening infectious episodes were recorded within 100 days from transplant in this selected group of paediatric patients. Overall 46% of patients were alive at a median of 461 days from SCT, but 50% of them developed chronic GVHD. In our experience, daclizumab proved to be a useful and safe treatment for refractory and steroid-resistant/dependent aGVHD, in particular for cutaneous and low-moderate intestinal involvement.