Etanercept for steroid-refractory acute graft-versus-host disease: A single center experience

De Jong, Cornelis N.; Saes, Lotte; Klerk, Clara P. W.; Van der Klift, Marjolein; Cornelissen, Jan J.; Broers, Annoek E. C.

Some studies, however, report better overall response and survival rates as compared to our cohort of patients. Kennedy et al. retrospectively studied the outcome of 16 patients, median age 42 years, with SR-aGVHD treated with a combination of ATG, tacrolimus and etanercept with or without MMF and reported an significantly higher ORR of 81% and OS of 50% [10] . In this analysis patients with less severe aGvHD were also included, with severity of gut GvHD ranging from stage 0 to 4. Xhaard et al. compared survival and infection rates in patients receiving MMF (56%), inolimomab (22%), or etanercept (23%) in addition to steroids and calcineurin inhibitors in SR-aGVHD [14] . The etanercept treated patients were younger than our cohort with a median age of 46 years (range 10-60 years). Most of them had high-stage gut involvement. Treatment response rate was 28% in etanercept treated patients. Two-year survival was 30% (95% CI: 22-41) and was not significantly different among the groups. Busca et al. reported on the use of etanercept in 13 SR-aGvHD patients [8] . This cohort compares well to ours with respect to age (median 52 yeara, range 26-70 years), but is more heterogeneous with respect to aGvHD severity and comprises fewer patients with stage 3 to 4 gut involvement. Overall response rate was 46% and 69% of patients were alive at a median followup of 429 days (range 71-1007 days).