The purpose of this study is to evaluate the efficacy of ruxolitinib in combination with methylprednisolone as first line therapy in patients with Grades II to IV acute graft-versus-host disease (GVHD).
Treatment: Once patients are diagnosed with grade II\~IV acute GVHD, the combination therapy should be initiated as soon as possible. 1. Methylprednisolone: 2mg/kg/d, iv or iv gtt, in two or three divided doses. Taper steroid every one or two weeks according to patient's response. 2. Ruxolitinib 5\~10mg bid po for at least 28 days. If patient's ANC\<0.5×10e9/L or PLT\< 20×10e9/L, cease ruxolitinib until recovery of ANC higher than 0.5×10e9/L or PLT higher than 20×10e9/L. Indication for stopping Ruxolitinib treatment: 1. No response after ruxolitinib treatment for 28 days. 2. Develop life-threatening complication. 3. ANC\<0.5×10e9/L or PLT\< 20×10e9/L. Indication for second line acute GVHD treatment: 1. deterioration of acute GVHD in 3 days 2. no response after 7 days 3. no complete remission after 2 weeks. Suggestions of second line therapy: Basiliximab 20mg, d1, d4, d8.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
1
Ruxolitinib Oral Tablet (Jakafi), 5\~10mg bid po for at least 28 days.
Methylprednisolone: 2mg/kg/d , iv or iv gtt, for at least 1 week, then taper accordingly.
Shanghai General Hospital
Shanghai, Shanghai Municipality, China
overall response rate
overall response rate of acute GVHD treatment, including complete response rate and partial response rate after combination therapy.
Time frame: 28 days after treatment
time to response
days from beginning to the first day of maximum response
Time frame: 28 days after treatment
reactivation rate of cytomegalovirus
reactivation rate of cytomegalovirus infection
Time frame: 100 days within transplant
1 year incidence of chronic GVHD
incidence of chronic GVHD 1 year after transplant
Time frame: 1 year within transplant
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