Effectiveness of ibrutinib in the management of chronic GVHD

• Published in: Transfusion and apheresis science 2024-12, Vol.64 (1), p.104052, Article 104052
• Main Authors: Erkurt, Mehmet Ali, Sarici, Ahmet, Sahin, Abdulkadir, Berber, Ilhami, Korkmaz, Gulten, Kuku, Irfan, Dal, Mehmet Sinan, Korkmaz, Serdal, Ulas, Turgay, Altuntas, Fevzi
• Format: Article
• Language: English
• Subjects: Allogeneic hematopoietic stem cell transplantation; Corticosteroid-resistant chronic graft-versus-host disease; Ibrutinib; Management
• ISSN: 1473-0502
• DOI: 10.1016/j.transci.2024.104052

Chronic graft-versus-host disease (cGVHD) represents a significant adverse event that may ensue following allogeneic hematopoietic stem cell transplantation (Allo-HSCT). In patients resistant to corticosteroids, which is the first-line treatment for cGVHD, ibrutinib is being evaluated as a potential treatment option. In this study, we aimed to share the findings of our multicenter study regarding the outcomes of ibrutinib treatment in patients with corticosteroid-resistant cGVHD who had previously received multiple systemic therapies. A retrospective analysis was conducted to examine the clinical characteristics and outcomes of patients who received ibrutinib treatment for corticosteroid-resistant cGVHD after Allo-HSCT. A total of 24 patients diagnosed with cGVHD who received ibrutinib treatment were included in the study. The median age of the patients was 34.5 (20–67). The included patients were followed for a median of 6 (1–30) months. All patients had stem cells collected from the peripheral blood. Fifty percent of the patients had multiple organ involvement, while the other 50 % had single organ involvement. The most frequently affected organs were skin and liver. On average, patients received four (3–5) lines of systemic therapy before ibrutinib treatment. At week 24 of ibrutinib treatment, 10 patients (41.7 %) had a complete response, and 10 patients (41.7 %) had a partial response; at week 48, 8 patients (33.3 %) had a complete response, and 10 patients (41.7 %) had a partial response. The most common hematological side effect after ibrutinib treatment was thrombocytopenia in 5 out of 24 patients, while the most common non-hematological side effect was CMV infection in 6 out of 24 patients. In patients with corticosteroid-resistant cGVHD, ibrutinib treatment has been demonstrated to be an efficacious option exhibiting an elevated overall response rate and a tolerable side effect profile.