Keywords
Stem Cell Transplantation
belumosudil
How to Cite
Abstract
La enfermedad de injerto contra huésped crónica (EICHc) es un trastorno inflamatorio y fibroesclerosante inmunomediado que se caracteriza por daño tisular y afectación de órganos multisistémico(1). Es la principal causa de morbilidad, mortalidad tardía sin recaída y deterioro de la calidad de vida después de un trasplante alogénico de células hematopoyéticas (aloTCH)(1-4). La EICHc afecta hasta el 50 % de todos los receptores de aloTCH(2). La fisiopatología involucra una desregulación de células T y B con una reparación deficiente de los tejidos con la consecuente reacción fibrótica(1). El tratamiento estándar de primera línea en las formas moderadas y severas se basa en esteroides, con o sin la asociación de inhibidores de calcineurina o sirolimus(5). Hasta 70% de los pacientes requerirán líneas adicionales de tratamiento(6). Actualmente se encuentran aprobados como tratamientos de segunda línea ruxolitinib (inhibidor selectivo del JAK1 y JAK2, basado en estudio clínico fase 3) e ibrutinib (inhibidor BTK, basado en estudio fase 2)(7). El 16 de julio de 2021, la Administración de Drogas y Alimentos (FDA) aprobó el belumosudil, para pacientes adultos y pediátricos mayores de 12 años o más con EICHc después del fracaso de al menos dos líneas previas de terapia sistémica(7). El belumosudil es un inhibidor selectivo de ROCK2 (del inglés Rho-associated coiled-coil containing kinase2). ROCK2 es una serina/treonina quinasa que regula múltiples funciones celulares, incluida la organización del citoesqueleto, la migración celular, y transcripción de genes(8-10).
References
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