by Elana Gotkine
Credit: CC0 Public Domain
For patients with haploidentical hematopoietic cell transplantation (haplo-HCT), the addition of itacitinib to standard graft versus host disease (GvHD) prophylaxis is well tolerated and results in low rates of cytokine release syndrome (CRS), according to a study published online Nov. 2 in Blood.
Noting that posttransplant cyclophosphamide (PtCy) has improved GvHD prophylaxis in haplo-HCT, but that patients continue to experience life-threatening complications, Ramzi Abboud, M.D., from the Washington University School of Medicine in St. Louis, and colleagues examined the effect of adding the JAK-1 selective inhibitor itacitinib to PtCy-haplo-HCT in an open-label, single-arm study. Forty-two patients were treated with itacitinib 200 mg daily from day −3 to +100 or +180.
The researchers found that itacitinib resulted in low CRS grades; 22, 78, and 0 percent of patients had grades 0, 1, and 2 to 5, respectively. No cases of primary graft failure were reported.
At day +100, the cumulative incidence of grade 2 acute GvHD was 21.9 percent; no patients developed grade 3 to 4 acute GvHD at day +180. There was a 5 percent one-year cumulative incidence of moderate or severe chronic GvHD. At two years, the cumulative incidence of relapse was 14 percent.
At one year, overall survival was 80 percent. At day 180, the cumulative incidence of nonrelapse mortality was 8 percent.
“We saw no severe GvHD, and the rates of relapse were lower than expected in these high-risk patients,” senior author John F. DiPersio, M.D., Ph.D., also from the Washington University School of Medicine, said in a statement.
“Low GvHD rates and low relapse resulted in very encouraging survival for the patients in this study.”
More information: Ramzi Abboud et al, Itacitinib for Prevention of Graft-Versus-Host Disease and Cytokine Release Syndrome with T-Cell Replete Peripheral Blood Haploidentical Transplantation, Blood (2023). DOI: 10.1182/blood-2023-180289
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