Vedolizumab for second-line treatment of steroid-refractory gastrointestinal late acute graft-versus-host disease

Vedolizumab for second-line treatment of steroid-refractory gastrointestinal late acute graft-versus-host disease

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Background: Late acute graft-versus-host disease (aGVHD) is a complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with little data regarding treatment and outcomes.There is no standard treatment for gastrointestinal (GI) late aGVHD, especially for Boxes steroid-refractory (SR) GI late aGVHD.Vedolizumab, a monoclonal antibody inhibiting the migration of both naive and activated lymphocytes into the GI endothelium, has been verified to be effective for SR GI aGVHD.Methods: We retrospectively analyzed the clinical efficacy and safety of vedolizumab as the second line for SR GI late aGVHD in seven patients after allo-HSCT.Results: Four patients received two doses of vedolizumab infusion, while three patients received only one dose of vedolizumab infusion.

The complete response and partial response rates were 57.1% (4/7) and 42.9% (3/7), respectively.No patient progressed to chronic GVHD during the period of follow-up.There was no severe adverse event related to vedolizumab.

Conclusion: Our data suggest that vedolizumab is expected to ameliorate SR GI late aGVHD.Further data on the treatment timing, efficacy, and AEG SKK8182VZC Integrated Tower Fridge A++ safety of vedolizumab are warranted in prospective clinical trials.