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Title: | Improved survival after LTx-associated acute GVHD with mAb therapy targeting IL2RAb and soluble TNFAb: Single-center experience and systematic review | Authors: | Minnee, R. C. FIEUWS, Steffen Jochmans, I. Aerts, R. Barriga, M. Sainz Debaveye, Y. Maertens, J. Vandenberghe, P. Laleman, W. van der Merwe, S. Verslype, C. CASSIMAN, David Ferdinande, P. Nevens, F. Pirenne, J. Monbaliu, D. |
Issue Date: | 2018 | Publisher: | WILEY | Source: | AMERICAN JOURNAL OF TRANSPLANTATION, 18(12), p. 3007-3020 | Abstract: | Acute graft-versus-host disease (GVHD) after liver transplant (LTx) is a rare complication with a high mortality rate. Recently, monoclonal antibody (mAb) treatment, specifically with anti-interleukin 2 receptor antibodies (IL2RAb) and anti-tumor necrosis factor-alpha antibodies (TNFAb), has gained increasing interest. However, evidence is mostly limited to case reports and the efficacy remains unclear. Here, we describe 5 patients with LTx-associated GVHD from our center and provide the results of our systematic literature review to evaluate the potential therapeutic benefit of IL2RAb/TNFAb treatment. Of the combined population of 155 patients (5 in our center and 150 through systematic search), 24 were given mAb (15.5%)-4 with TNFAb (2.6%) and 17 with IL2RAb (11%) ("mAb group")-and compared with patients who received other treatments (referred to as "no-mAb group"). Two-sided Fisher exact tests revealed a better survival when comparing treatment with mAb versus no-mAb (11/24 vs 27/131; P = .018), TNFAb versus no-mAb (3/4 vs 27/131; P = .034), and IL2RAb versus no-mAb (8/17 vs 27/131; P = .029). This systematic review suggests a beneficial effect of mAb treatment and a promising role for TNFAb and IL2RAb as a first-line strategy to treat LTx-associated acute GVHD. | Notes: | [Minnee, R. C.; Jochmans, I.; Aerts, R.; Barriga, M. Sainz; Pirenne, J.; Monbaliu, D.] Univ Hosp Leuven, Abdominal Transplant Surg & Transplantat Coordina, Leuven, Belgium. [Minnee, R. C.; Jochmans, I.; Aerts, R.; Barriga, M. Sainz; Pirenne, J.; Monbaliu, D.] Katholieke Univ Leuven, Dept Microbiol & Immunol, Leuven, Belgium. [Fieuws, S.] Univ Leuven, KU Leuven, Interuniv Inst Biostat & Stat Bioinformat, Leuven, Belgium. [Fieuws, S.] Univ Hasselt, Hasselt, Belgium. [Debaveye, Y.; Ferdinande, P.] Univ Hosp Leuven, Dept Intens Care Med, Leuven, Belgium. [Debaveye, Y.; Ferdinande, P.] Katholieke Univ Leuven, Div Cellular & Mol Med, Lab Intens Care Med, Leuven, Belgium. [Maertens, J.; Vandenberghe, P.] Univ Hosp Leuven, Dept Hematol, Leuven, Belgium. [Vandenberghe, P.] Univ Hosp Leuven, Ctr Human Genet, Leuven, Belgium. [Laleman, W.; van der Merwe, S.; Verslype, C.; Cassiman, D.; Nevens, F.] Univ Hosp Leuven, Dept Hepatol, Leuven, Belgium. | Keywords: | clinical research/practice; complication; graft-versus-host disease (GVHD); liver transplantation/hepatology;clinical research/practice; complication; graft-versus-host disease (GVHD); liver transplantation/hepatology | Document URI: | http://hdl.handle.net/1942/28868 | ISSN: | 1600-6135 | e-ISSN: | 1600-6143 | DOI: | 10.1111/ajt.14923 | ISI #: | 000451112200022 | Rights: | 2018 The American Society of Transplantation and the American Society of Transplant Surgeons | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2019 |
Appears in Collections: | Research publications |
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