Article ; Online: Real-world experience with low-dose IL-2 for children and young adults with refractory chronic graft-versus-host disease.
2023 Volume 7, Issue 16, Page(s) 4647–4657
Abstract: ... world experience with LD IL-2 in 15 children and young adults. We conducted a retrospective chart review ... creating a need for safe and effective therapies. Subcutaneous low-dose interleukin-2 (LD IL-2 ... of patients with SR-cGVHD at our center who received LD IL-2 from August 2016 to July 2022 not on a research ...
| Abstract | The majority of patients with chronic graft-versus-host disease (cGVHD) are steroid refractory (SR), creating a need for safe and effective therapies. Subcutaneous low-dose interleukin-2 (LD IL-2), which preferentially expands CD4+ regulatory T cells (Tregs), has been evaluated in 5 clinical trials at our center with partial responses (PR) in ∼50% of adults and 82% of children by week 8. We now report additional real-world experience with LD IL-2 in 15 children and young adults. We conducted a retrospective chart review of patients with SR-cGVHD at our center who received LD IL-2 from August 2016 to July 2022 not on a research trial. The median age at start of LD IL-2 was 10.4 years (range, 1.2-23.2 years) at a median of 234 days from cGVHD diagnosis (range, 11-542 days). Patients had a median of 2.5 (range, 1-3) active organs at LD IL-2 start and received a median of 3 (range, 1-5) prior therapies. The median duration of LD IL-2 therapy was 462 days (range, 8-1489 days). Most patients received 1 × 106 IU/m2 per day. There were no serious adverse effects. The overall response rate in 13 patients who received >4 weeks of therapy was 85% (complete response, n = 5; PR, n = 6) with responses in diverse organs. Most patients significantly weaned corticosteroids. Tregs preferentially expanded with a median peak fold increase of 2.8 in the ratio of Tregs to CD4+ conventional T cells (range, 2.0-19.8) by 8 weeks on therapy. LD IL-2 is a well-tolerated, steroid-sparing agent with a high response rate in children and young adults with SR-cGVHD. |
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| MeSH term(s) | Child ; Humans ; Young Adult ; Graft vs Host Disease/drug therapy ; Graft vs Host Disease/etiology ; Immunotherapy ; Interleukin-2/administration & dosage ; Retrospective Studies ; Infant ; Child, Preschool ; Adolescent |
| Chemical Substances | Interleukin-2 |
| Language | English |
| Publishing date | 2023-08-21 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural |
| ZDB-ID | 2915908-8 |
| ISSN | 2473-9537 ; 2473-9529 |
| ISSN (online) | 2473-9537 |
| ISSN | 2473-9529 |
| DOI | 10.1182/bloodadvances.2023009729 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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