Outcome of Ruxolitinib and Sirolimus in Preventing aGVHD Post to HLA Matched Hemotopietic Stem Cell Transplantation

Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment for hematological malignancies. Graft-versus-host disease (GVHD) is an important cause of graft failure and death. At present, the classic prevention program of GVHD is cyclosporine and calcineurin inhibitor (CNI; i.e. tacrolimus) plus methotrexate (CTX) or mycophenolate mofetil (MMF). However, the incidence of aGVHD is about 30-50%. Furthermore, the classic preventive regimen can also inhibit the graft-versus-leukemia effective (GVL) effect while reducing aGVHD, thereby increasing the recurrence rate, slowing the immune reconstitution, increasing the opportunistic infection. Ruxolitinib is a selective JAK1/2 small molecule kinase inhibitor, which has been reported to have a significant effect on the treatment of GVHD, while retaining the GVL effect with mild side effects. Sirolimus is a macrolide antibiotic with antifungal, immunosuppressive and antitumor effects. Based on the above studies, it can be speculated that the combination of ruxolitinib and sirolimus may have the function of immune inhibition, anti-tumor, while retaining the GVL effect, reducing the recurrence rate and reducing the risk of infection. Here we report our experience of using the combination of ruxolitinib and sirolimus to prevent the occurrence of aGVHD post to HLA matched hematopoietic stem cell transplantation and analyzed the incidence and prognosis of aGVHD.1. Patients and Methods1.1 Patients: There were five pati...
Source: Blood - Category: Hematology Authors: Tags: 722. Clinical Allogeneic Transplantation: Acute and Chronic GVHD, Immune Reconstitution Source Type: research

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