Objective: To study the feasibility of CD25 monoclonal antibody (basiliximab) in the treatment of severe III-IV intestinal acute graft-versus-host disease (GVHD) following haploidentical hematopoietic stem cell transplantation (HSCT).
Methods: Twenty patients, 13 males and 7 females, who developed III-IV intestinal acute GVHD after haplotypic HSCT between October 2004 and September 2009, were treated with basiliximab (20 mg/d, d1, 4) and prednisolone (1 mg×kg(-1)×d(-1)) from the day of diagnosis. The therapy was repeated in the second week if the intestinal symptoms showed no improvement. The therapeutic effect was analyzed and the adverse reaction and cytomegalovirus (CMV) infection were observed.
Results: Ten patients had a complete remission and 5 were in a partial remission. The total effective rate was 75.0%. The clinical symptoms started to lessen in 1-12 days after using basiliximab (average: 7 days). During the 6-64 month follow-up (average: 25 months), 8/10 cases with a complete remission had no acute GVHD relapse, and the other 2 relapsing patients experienced a remission after a re-administration of basiliximab. Nine patients survived with a longest period of 64 months. Four withdrew corticosteroids and the other 5 stayed on a low-dose maintenance corticosteroid regimen. The 2-year disease-free survival was 47.5% by Kaplan-Meier calculation.
Conclusions: Basiliximab is feasible in the treatment of III-IV intestinal acute GVHD after haplotype HSCT. It does not increase the relapse of leukemia or the incidence of infections.