{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:38:38Z","timestamp":1793234318230,"version":"4.5.0"},"reference-count":28,"publisher":"American Society of Hematology","issue":"5","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3,11]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>To examine the activity of ibrutinib in steroid-refractory chronic graft-versus-host disease (SR-cGVHD) after the US Food and Drug Administration approval, we conducted a multicenter retrospective study. Data were standardly collected (N\u00a0=\u00a0270 from 19 centers). Involved organs included skin (75%), eye (61%), mouth (54%), joint\/fascia (47%), gastrointestinal (GI) (26%), lung (27%), liver (19%), genital (7%), and others (4.4%). The National Institutes of Health (NIH) severity was mild in 5.7%, moderate 42%, and severe 53%. Thirty-nine percent had overlap subtype. Karnofsky performance status (KPS) was \u226580% in 72%. The median prednisone was 0.21\u00a0mg\/kg (0-2.27). Ibrutinib was started at a median of 18.2\u00a0months after cGVHD onset and in earlier lines of therapy (second line, 26%; third, 30%; fourth, 21%; fifth, 9.6%; sixth, 10%; seventh or higher, 1.2%). Among evaluable patients, the 6-month NIH overall response rate (ORR; complete response [CR]\/partial response [PR]) was 45% (PR 42%; CR 3%). The median duration of response was 15\u00a0months (range, 1-46). Liver involvement had association with 6-month ORR (multivariate [MVA] odds ratio, 5.49; 95% confidence interval [CI], 2.3-14.2; P\u00a0&amp;lt; .001). The best overall response was 56%, with most (86%) achieving by 1 to 3\u00a0months. With a median follow-up for survivors of 30.5\u00a0months, failure-free survival (FFS) was 59% (53%-65%) at 6\u00a0months and 41% (36%-48%) at 12\u00a0months. On MVA, increased age (hazard ratio [HR], 1.01; 95%\u00a0CI, 1.0-1.02; P\u00a0=\u00a0.033), higher baseline prednisone (HR, 1.92; 95%\u00a0CI, 1.09-3.38; P\u00a0=\u00a0.032), and lung involvement (HR, 1.58; 95%\u00a0CI, 1.1-2.28; P\u00a0=\u00a0.016) had worse FFS. Ibrutinib discontinuation was most commonly due to progressive cGVHD (44%) or toxicity (42%). These data support that ibrutinib has activity in SR-cGVHD, provide new insight into factors associated with response and FFS, and demonstrate the toxicity profile associated with discontinuation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/bloodadvances.2024014374","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T17:54:57Z","timestamp":1729878897000},"page":"1040-1048","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":23,"title":["Ibrutinib for therapy of steroid-refractory chronic graft-versus-host disease: a multicenter real-world analysis"],"prefix":"10.1182","volume":"9","author":[{"given":"Joseph","family":"Pidala","sequence":"first","affiliation":[{"name":"1Department of Blood and Marrow Transplantation and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7430-2226","authenticated-orcid":false,"given":"Jongphil","family":"Kim","sequence":"additional","affiliation":[{"name":"2Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Kalos","sequence":"additional","affiliation":[{"name":"2Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey","family":"Cutler","sequence":"additional","affiliation":[{"name":"3Division of Transplantation and Cellular Therapy, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7994-8974","authenticated-orcid":false,"given":"Zachariah","family":"DeFilipp","sequence":"additional","affiliation":[{"name":"4Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E. D.","family":"Flowers","sequence":"additional","affiliation":[{"name":"5Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1252-6539","authenticated-orcid":false,"given":"Betty K.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"6Blood and Marrow Transplant Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4504-398X","authenticated-orcid":false,"given":"Kuo-Kai","family":"Chin","sequence":"additional","affiliation":[{"name":"7Memorial Sloan Kettering, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Rotta","sequence":"additional","affiliation":[{"name":"8Hematology\/Oncology, Colorado Blood Cancer Center, Denver, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9268-9655","authenticated-orcid":false,"given":"Najla","family":"El Jurdi","sequence":"additional","affiliation":[{"name":"9Blood and Marrow Transplant Program, Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-510X","authenticated-orcid":false,"given":"Mehdi","family":"Hamadani","sequence":"additional","affiliation":[{"name":"10Division of Hematology & Oncology, Medical College of Wisconsin, Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6873-9571","authenticated-orcid":false,"given":"Gulrayz","family":"Ahmed","sequence":"additional","affiliation":[{"name":"11Blood and Marrow Transplant & Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Kitko","sequence":"additional","affiliation":[{"name":"12Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9422-5766","authenticated-orcid":false,"given":"Doris","family":"Ponce","sequence":"additional","affiliation":[{"name":"13Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Sung","sequence":"additional","affiliation":[{"name":"14Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8528-1435","authenticated-orcid":false,"given":"Helen","family":"Tang","sequence":"additional","affiliation":[{"name":"15Hospital of the University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nosha","family":"Farhadfar","sequence":"additional","affiliation":[{"name":"16Sarah Cannon Transplant & Cellular Therapy Program at Methodist Hospital, San Antonio, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eneida","family":"Nemecek","sequence":"additional","affiliation":[{"name":"17Center for Hematological Malignancies, Knight Cancer Institute, Oregon Health & Science University, Portland, OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1725-5184","authenticated-orcid":false,"given":"Iskra","family":"Pusic","sequence":"additional","affiliation":[{"name":"18Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7689-343X","authenticated-orcid":false,"given":"Muna","family":"Qayed","sequence":"additional","affiliation":[{"name":"19Aflac Cancer and Blood Disorders Center, Children\u2019s Healthcare of Atlanta and Emory University, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3371-2920","authenticated-orcid":false,"given":"Hemalatha","family":"Rangarajan","sequence":"additional","affiliation":[{"name":"20Department of Pediatric Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children\u2019s Hospital, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5841-4105","authenticated-orcid":false,"given":"William","family":"Hogan","sequence":"additional","affiliation":[{"name":"21Division 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