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Blood, 16 July 2009, Vol. 114, No. 3, pp. 719-722. Prepublished online as a Blood First Edition Paper on March 16, 2009; DOI 10.1182/blood-2009-02-204750.
TRANSPLANTATION Imatinib mesylate as salvage therapy for refractory sclerotic chronic graft-versus-host disease1 Service des Maladies du Sang, Centre Hospitalier Regional Universitaire de Lille, Lille; 2 Service d'Hématologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes; 3 Université de Nantes, Inserm, Centre de Recherche en Cancérologie de Nantes-Angers U892, Nantes; 4 Service de Dermatologie and 5 EA2686, Centre Hospitalier Regional Universitaire de Lille, Lille; and 6 Centre d'Investigation Clinique en Cancéralogie, Nantes, France
Imatinib is a promising candidate for the treatment of fibrotic diseases. This retrospective study evaluated the use of imatinib for the treatment of refractory sclerotic chronic graft-versus-host disease in 14 patients with different hematologic malignancies. Imatinib was started at a median of 44 months after transplantation (range, 16-119 months after transplantation) and was administered for a median of 5.9 months from time of initiation (range, 2.1-74 months from time of initiation). With a median overall follow-up of 11.6 months from time of initiation (range, 4.1-74 months from time of initiation) of imatinib, 4 patients (29%) had to stop imatinib because of drug intolerance. All other adverse reactions were of mild-to-moderate grade and could be managed symptomatically. Overall, 7 patients responded to imatinib (50%; 95% confidence interval, 24%-76%) with 4 patients improving their Rodman score more than or equal to 90%. In addition, imatinib therapy allowed for a significant reduction of corticosteroid dosage. Despite its limited size, this cohort suggests some beneficial activity of imatinib in sclerotic chronic graft-versus-host disease, warranting further prospective investigations.
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