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Swe Mar Linn, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Igor Novitzky-Basso, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Omar Abduljalil, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Ivan Pasic, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Wilson Lam, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Arjun Law, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Fotios V. Michelis, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Armin Gerbitz, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Auro Viswabandya, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Jeffrey Lipton, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Rajat Kumar, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Jonas Mattsson, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network
Dennis Dong Hwan Kim, Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health NetworkFollow

Abstract

Background: Chronic graft-versus-host-disease (cGVHD) is a common cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation (HCT). Tyrosine kinase inhibitors (TKIs), including Ruxolitinib, Imatinib and Ibrutinib, have shown promising efficacy in cGVHD treatment. Method: A total of 43 patients who developed cGVHD and received at least one line of TKI therapy for cGVHD treatment were evaluated retrospectively. Overall response, clinical benefit (CB), corticosteroid dose reduction, failure-free (FFS) and overall survival (OS) were assessed. Result: A total 62 lines of TKI therapy were evaluated, including Ruxolitinib (n=18), Ibrutinib (n=13), and Imatinib (n=31). With a median follow-up duration of 12 months, 19/58 (32.8%), 20/41 (48.7%) and 17/29 (58.6%) responded to TKI therapy at 3, 6 and 12 months, respectively. We observed clinical benefit in 80% of patients over time, allowing prednisone dose reduction in all 3 TKI. The FFS rate at 12 months was similarly higher in Imatinib (71%) or Ruxolitinib groups (67%) than Ibrutinib group (46%), while OS rate at 12 months was similar among the 3 groups at 96% to 100% in overall patients. In the sclerotic GVHD patient subgroup (n=39), ORR gradually increased over time. Ruxolitinib seems as effective as Imatinib and improved PROM score gradually in sclerotic GVHD patients. Conclusion: TKI drugs Ruxolitinib, Imatinib and Ibrutinib are effective and feasible for cGVHD treatment. Ruxolitinib is as effective as Imatinib for sclerotic GVHD.

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