J Clin Oncol:Abatacept协同刺激阻断可明显有效预防急性GVHD!

2021-01-26 MedSci原创 MedSci原创

重度(3-4级)急性移植物抗宿主病(AGVHD)是患者非亲缘关系(URD)造血细胞移植后死亡的主要原因,尤其是HLA不相合移植后死亡率更高。目前还没有获得批准的AGVHD预防药物,这突显了对新疗法的迫

重度(3-4级)急性移植物抗宿主病(AGVHD)是患者非亲缘关系(URD)造血细胞移植后死亡的主要原因,尤其是HLA不相合移植后死亡率更高。目前还没有获得批准的AGVHD预防药物,这突显了对新疗法的迫切需求。

ABA2是一项II期试验,旨在严格评估在以钙调神经磷酸酶抑制剂(CNI)/甲氨蝶呤(MTX)为基础的移植物抗宿主病(GVHD)预防中加入含有阿巴西普(abatacept)的T细胞共刺激阻滞的安全性、有效性和免疫学效应,以测试阿巴西普是否能降低AGVHD风险。

研究流程

招募恶性血液病成人和儿童患者,分成了两个队列:1)随机双盲安慰剂为对照的队列(8/8-HLA-matched URD),对比了CNI/MTX+阿巴西普 vs CNI/MTX+安慰剂;2)单臂队列(7/8-HLA-mismatched URD),对比了CNI/MTX+阿巴西普 vs CNI/MTX CIBMTR对照。主要终点为100天后的3-4级AGVHD,次要终点为180天后的无重度AGVHD存活率(SGFS)。

两队列的3-4级AGVHD的累积发生率

8/8队列和7/8队列分别招募了142位移植受者(中位随访716天)和43位移植受者(708天)。在8/8队列内,3-4级AGVHD的发生率分别为6.8%(阿巴西普组)和6.8%(安慰剂组)(p=0.13,危险比[HR] 0.45);无重度AGVHD存活率(SGFS)分别为93.2%(阿巴西普组)和82%(安慰剂组,p=0.05)

两队列SGFS的可能性

在较小的7/8队列中,CNI/MTX联合阿巴西普组的3-4级AGVHD发生率为2.3%,明显优于CNI/MTX的非随机匹配队列(30.2%,p<0.001);而且SGFS的优势更明显(97.7% vs 58.7%,p<0.001)。免疫学分析显示,采用阿巴西普治疗的患者的T细胞活化得到了控制。

综上,在URD HCT过程中加用阿巴西普的安全性良好,可减少AGVHD发生率,改善SGFS。该结果表明,阿巴西普可以显著改善与AGVHD相关的移植预后,尤其是对于HLA不相合的HCT的影响。

原始出处:

Watkins Benjamin,Qayed Muna,McCracken Courtney et al. Phase II Trial of Costimulation Blockade With Abatacept for Prevention of Acute GVHD. J Clin Oncol, 2021, undefined: JCO2001086.

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    2021-02-02 grace5700
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    2021-08-27 minlingfeng
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    2021-06-15 日月
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createdName=minlingfeng, createdTime=Fri Aug 27 14:33:33 CST 2021, time=2021-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1930318, encodeId=932619303182c, content=<a href='/topic/show?id=87b8322658' target=_blank style='color:#2F92EE;'>#BAT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3226, encryptionId=87b8322658, topicName=BAT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4a4d285, createdName=日月, createdTime=Tue Jun 15 21:33:33 CST 2021, time=2021-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1779329, encodeId=51961e79329c4, content=<a href='/topic/show?id=c33118392a' target=_blank style='color:#2F92EE;'>#ACEP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1839, encryptionId=c33118392a, topicName=ACEP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Sat May 15 15:33:33 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710270, encodeId=0d3e1e10270b3, content=<a href='/topic/show?id=7ac59e67604' target=_blank style='color:#2F92EE;'>#阻断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97676, encryptionId=7ac59e67604, topicName=阻断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5ca31824852, createdName=41514497@qq.com, createdTime=Wed Oct 06 19:33:33 CST 2021, time=2021-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=961839, encodeId=4114961839cf, content=<a href='/topic/show?id=11cf104251a3' target=_blank style='color:#2F92EE;'>#J Clin Oncol#</a>点击查看更多该期刊内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104251, encryptionId=11cf104251a3, topicName=J Clin Oncol)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Fri Apr 30 17:15:51 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778953, encodeId=cd5e1e7895342, content=<a href='/topic/show?id=c33118392a' target=_blank style='color:#2F92EE;'>#ACEP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1839, encryptionId=c33118392a, topicName=ACEP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Fri Apr 30 20:33:33 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656046, encodeId=fb18165604690, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Wed Dec 29 02:33:33 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466106, encodeId=d3fd14661062c, content=<a href='/topic/show?id=217c292009' target=_blank style='color:#2F92EE;'>#ATA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2920, encryptionId=217c292009, topicName=ATA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Thu Jan 28 14:33:33 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038191, encodeId=042610381917d, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Wed Jan 27 02:33:33 CST 2021, time=2021-01-27, status=1, ipAttribution=)]
    2021-05-15 xiaoyeshuang
  5. [GetPortalCommentsPageByObjectIdResponse(id=2033732, encodeId=ad402033e323b, content=<a href='/topic/show?id=fc431e0708f' target=_blank style='color:#2F92EE;'>#TAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17070, encryptionId=fc431e0708f, topicName=TAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b05b180, createdName=grace5700, createdTime=Tue Feb 02 18:33:33 CST 2021, time=2021-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865989, encodeId=e79618659899a, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, 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topicName=ACEP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Sat May 15 15:33:33 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710270, encodeId=0d3e1e10270b3, content=<a href='/topic/show?id=7ac59e67604' target=_blank style='color:#2F92EE;'>#阻断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97676, encryptionId=7ac59e67604, topicName=阻断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5ca31824852, createdName=41514497@qq.com, createdTime=Wed Oct 06 19:33:33 CST 2021, time=2021-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=961839, encodeId=4114961839cf, content=<a href='/topic/show?id=11cf104251a3' target=_blank style='color:#2F92EE;'>#J Clin Oncol#</a>点击查看更多该期刊内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104251, encryptionId=11cf104251a3, topicName=J Clin Oncol)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Fri Apr 30 17:15:51 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778953, encodeId=cd5e1e7895342, content=<a href='/topic/show?id=c33118392a' target=_blank style='color:#2F92EE;'>#ACEP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1839, encryptionId=c33118392a, topicName=ACEP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Fri Apr 30 20:33:33 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656046, encodeId=fb18165604690, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Wed Dec 29 02:33:33 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466106, encodeId=d3fd14661062c, content=<a href='/topic/show?id=217c292009' target=_blank style='color:#2F92EE;'>#ATA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2920, encryptionId=217c292009, topicName=ATA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Thu Jan 28 14:33:33 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038191, encodeId=042610381917d, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Wed Jan 27 02:33:33 CST 2021, time=2021-01-27, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2033732, encodeId=ad402033e323b, content=<a href='/topic/show?id=fc431e0708f' target=_blank style='color:#2F92EE;'>#TAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17070, encryptionId=fc431e0708f, topicName=TAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b05b180, createdName=grace5700, createdTime=Tue Feb 02 18:33:33 CST 2021, time=2021-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865989, encodeId=e79618659899a, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, 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topicName=ACEP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Sat May 15 15:33:33 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710270, encodeId=0d3e1e10270b3, content=<a href='/topic/show?id=7ac59e67604' target=_blank style='color:#2F92EE;'>#阻断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97676, encryptionId=7ac59e67604, topicName=阻断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5ca31824852, createdName=41514497@qq.com, createdTime=Wed Oct 06 19:33:33 CST 2021, time=2021-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=961839, encodeId=4114961839cf, content=<a href='/topic/show?id=11cf104251a3' target=_blank style='color:#2F92EE;'>#J Clin Oncol#</a>点击查看更多该期刊内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104251, encryptionId=11cf104251a3, topicName=J Clin Oncol)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Fri Apr 30 17:15:51 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778953, encodeId=cd5e1e7895342, content=<a href='/topic/show?id=c33118392a' target=_blank style='color:#2F92EE;'>#ACEP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1839, encryptionId=c33118392a, topicName=ACEP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Fri Apr 30 20:33:33 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656046, encodeId=fb18165604690, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Wed Dec 29 02:33:33 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466106, encodeId=d3fd14661062c, content=<a href='/topic/show?id=217c292009' target=_blank style='color:#2F92EE;'>#ATA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2920, encryptionId=217c292009, topicName=ATA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Thu Jan 28 14:33:33 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038191, encodeId=042610381917d, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Wed Jan 27 02:33:33 CST 2021, time=2021-01-27, status=1, ipAttribution=)]
    2021-04-30 MedSciZeng

    #J Clin Oncol#点击查看更多该期刊内容

    0

  7. 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createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Thu Jan 28 14:33:33 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038191, encodeId=042610381917d, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Wed Jan 27 02:33:33 CST 2021, time=2021-01-27, status=1, ipAttribution=)]
    2021-04-30 xiaoyeshuang
  8. 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createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Thu Jan 28 14:33:33 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038191, encodeId=042610381917d, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Wed Jan 27 02:33:33 CST 2021, time=2021-01-27, status=1, ipAttribution=)]
    2021-12-29 shanyongle
  9. 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createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Thu Jan 28 14:33:33 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038191, encodeId=042610381917d, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Wed Jan 27 02:33:33 CST 2021, time=2021-01-27, status=1, ipAttribution=)]
    2021-01-28 bbjsj_1981
  10. 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createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Thu Jan 28 14:33:33 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038191, encodeId=042610381917d, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Wed Jan 27 02:33:33 CST 2021, time=2021-01-27, status=1, ipAttribution=)]
    2021-01-27 anti-cancer

    谢谢梅斯分享这么多精彩信息

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