Sirolimus versus imatinib in patients with steroid-refractory chronic graft-versus-host disease: a retrospective analysis of a single-center

Yundi HE; Ruihao HUANG; Tao HONG; Weihao WANG; Yuxuan DU; Xiaoqi WANG; Zheng WANG; Yunfang ZHANG; Xi ZHANG

doi:10.16016/j.1000-5404.202108067

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Sirolimus versus imatinib in patients with steroid-refractory chronic graft-versus-host disease: a retrospective analysis of a single-center

Monographic Reports: Basic and clinical research on complications after hematopoietic stem cell transplantation | 更新时间：2026-02-13

- Sirolimus versus imatinib in patients with steroid-refractory chronic graft-versus-host disease: a retrospective analysis of a single-center
- Journal of Third Military Medical University Vol. 43, Issue 21, Pages: 2313-2320(2021)
- 作者机构：
  
  1.400037 重庆，陆军军医大学(第三军医大学)第二附属医院血液病医学中心，全军血液病中心，创伤、烧伤与复合伤国家重点实验室
  2.563099 贵州遵义，遵义医科大学第二附属医院检验科
- 作者简介：
- 基金信息：
  
  the (Regional) Cooperation and Exchange Project for National Natural Science Foundation of China(82020108004);the 2020 Open Project of National Clinical Medicine Research Center for Hematological System Diseases(2020ZKZC02);the Key Special Project of National Key R & D Program(2017YFA0105502)
- DOI：10.16016/j.1000-5404.202108067
  CLC： R617;R733.7;R976
- Received：10 August 2021，
  
  Revised：2021-09-17，
  
  Published：15 November 2021
- 稿件说明：
移动端阅览
Yundi HE, Ruihao HUANG, Tao HONG, et al. Sirolimus versus imatinib in patients with steroid-refractory chronic graft-versus-host disease: a retrospective analysis of a single-center[J]. Journal of Third Military Medical University, 2021, 43(21): 2313-2320.
DOI：

Yundi HE, Ruihao HUANG, Tao HONG, et al. Sirolimus versus imatinib in patients with steroid-refractory chronic graft-versus-host disease: a retrospective analysis of a single-center[J]. Journal of Third Military Medical University, 2021, 43(21): 2313-2320. DOI： 10.16016/j.1000-5404.202108067.

摘要

目的

对比西罗莫司和伊马替尼作为二线药物，治疗异基因干细胞移植后激素难治性慢性移植物抗宿主病(steroid-refractory chronic graft-versus-host disease，SR-cGVHD)的疗效和预后。

方法

回顾性分析2017年9月至2020年12月于我中心确诊为异基因造血干细胞移植后SR-cGVHD的33例患者临床资料，接受伊马替尼治疗16例，接受西罗莫司治疗17例。比较两组患者二线治疗后6个月和1年的缓解率、2年总生存(overall survival，OS)、2年无病生存(disease free survival，DFS)、1年无失败生存(failure free survival，FFS)和药物相关毒性。

结果

伊马替尼和西罗莫司治疗6个月整体缓解率分别是62.5%和41.2%(

=0.303)，1年整体缓解率分别是73.3%和43.8%(

=0.149)，6个月完全缓解率分别是12.5%和23.5%(

=0.656)，1年完全缓解率分别是20.0%和31.3%(

=0.685)，差异无统计学意义；伊马替尼2年OS和2年DFS均优于西罗莫司(

=0.041，

=0.043)；伊马替尼和西罗莫司的药物相关毒性率差异无统计学意义。

结论

伊马替尼和西罗莫司治疗SR-cGVHD缓解率疗效相当，伊马替尼在短期生存和无病生存方面优于西罗莫司。

Abstract

Objective

To compare the efficacy and prognosis of imatinib and sirolimus as second-line treatment for steroid-refractory chronic graft-versus-host disease (SR-cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

Methods

Clinical data of 33 patients diagnosed as SR-cGVHD after allo-HSCT in the Medical Center of Hematology of Army Medical University from September 2017 to December 2020 were collected and analyzed retrospectively. Among them

16 patients were treated with imatinib and 17 with sirolimus. The response rate at the time points of 6 months and 1 year after initiation of second-line treatment

2-year overall survival (OS)

2-year disease free survival (DFS)

1-year failure free survival and drug-related toxicity were compared between the 2 groups.

Results

For the imatinib and sirolimus patients

their 6-month overall response rate (ORR) was 62.5% and 41.2% (

=0.303)

while 1-year ORR was 73.3% and 43.8% (

=0.149)

6-month complete response (CR) rate was 12.5% and 23.5% (

=0.656)

while 1-year CR rate was 20.0% and 31.3% (

=0.685)

respectively

and no statistical significance was observed between the 2 groups. The patients with imatinib treatment achieved better outcomes than those treated with sirolimus in terms of 2-year OS and 2-year DFS (

=0.041

=0.043). There was no significant difference in the occurrence of drug-related toxicity between the 2 groups.

Conclusion

Imatinib and sirolimus shows similar response rate to SR-cGVHD after allo-HSCT

but the former is superior to the latter in terms of short-term OS and DFS.

关键词

Keywords

references

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