Sclerodermatous Chronic Graft-versus-Host Disease Treated With Imatinib: A Dermatological Perspective.
INTRODUCTION
Chronic graft-versus-host disease (cGVHD) is the most important cause of late non-relapse mortality after allogeneic hematopoietic stem cell transplantation. Sclerodermatous cGVHD is usually steroid refractory and remains a therapeutic challenge. Activating antibodies against the PDGFR have been reported in patients with sclerodermatous cGVHD. These antibodies induce PDGFR phosphorylation and lead to fibrosis. There is increasing evidence of successful treatment of sclerodermatous cGVHD with imatinib, a tyrosine kinase inhibitor.


OBJECTIVE
To evaluate the response of cutaneous sclerodermatous cGVHD to imatinib.


MATERIALS AND METHODS
Retrospective study of 18 patients with sclerodermatous cGVHD refractory to immunosuppressants treated with imatinib in a single center. Evaluation of treatment response was performed by clinicians' assessment and patients' subjective response at one, 3, 6, 9, 12 and 18 months after initiation of imatinib. Response was assessed as complete, partial, significant, no change or progression. Tapper off steroids was complete, partial or not possible.


RESULTS
In our series, 4 (22%) patients achieved complete response, 9 (50%) patients partial response, 2 (11%) patients significant response, 2 (11%) patients had no change and one (6%) patient progressive disease at last follow-up. Mean time from initiation of imatinib to any degree of response was 2,75 months (range 1-9 months).


CONCLUSIONS
This study provides further evidence of the role of imatinib for the treatment of steroid refractory sclerodermatous cGVHD.
['Molés-Poveda|P|P|', 'Montesinos|P|P|', 'Sanz-Caballer|J|J|', 'de Unamuno|B|B|', 'Piñana|J L|JL|', 'Sahuquillo|A|A|', 'Botella-Estrada|R|R|']
D000293:Adolescent D000328:Adult D002908:Chronic Disease D005260:Female D006086:Graft vs Host Disease D006801:Humans D000068877:Imatinib Mesylate D008297:Male D008875:Middle Aged D047428:Protein Kinase Inhibitors D012189:Retrospective Studies D012594:Scleroderma, Localized D016896:Treatment Outcome D055815:Young Adult
Graft-versus-host disease Imatinib Treatment Chronic sclerodermatous graft versus host disease Cutaneous graft versus host disease Enfermedad de injerto contra huésped Enfermedad de injerto contra huésped crónica esclerodermiforme Enfermedad de injerto contra huésped cutánea Platelet-derived growth factor receptor Receptor del factor de crecimiento derivado de plaquetas Tratamiento