Overlap chronic GVHD is associated with adverse survival outcomes compared to classic chronic GVHD.


Journal

Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459

Informations de publication

Date de publication:
21 Feb 2024
Historique:
received: 07 08 2023
accepted: 07 02 2024
revised: 20 12 2023
medline: 22 2 2024
pubmed: 22 2 2024
entrez: 21 2 2024
Statut: aheadofprint

Résumé

Chronic graft-versus-host-disease (cGVHD) is divided into two subtypes: classic (absence of acute GVHD features) and overlap cGVHD ('ocGVHD'), in which both chronic and acute GVHD clinical features are present simultaneously. While worse outcomes with ocGVHD have been reported, there are few recent analyses. We performed a secondary analysis of data from the ABA2 trial (N = 185), in which detailed GVHD data were collected prospectively and systematically adjudicated. Analyses included cumulative incidence of classic versus ocGVHD, their specific organ manifestations, global disease severity scores, non-relapse mortality (NRM), disease-free survival (DFS) and overall survival (OS) in these two cGVHD subtypes. Of 92 patients who developed cGVHD, 35 were classified as ocGVHD. The 1-year cumulative incidence, organ involvement, and global severity of classic and ocGVHD were similar between ABA2 patients receiving CNI/MTX+placebo and CNI/MTX+abatacept; thus, cohorts were combined for ocGVHD evaluation. This analysis identified ocGVHD as having significantly higher severity at presentation and at maximum global severity compared to classic cGVHD. OS and DFS were significantly lower for ocGVHD versus classic cGVHD. OcGVHD is associated with increased cGVHD severity scores, and is associated with decreased OS and DFS compared to classic cGVHD, underscoring the high risks with this cGVHD subtype.

Identifiants

pubmed: 38383714
doi: 10.1038/s41409-024-02245-y
pii: 10.1038/s41409-024-02245-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Nature Limited.

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Auteurs

Lev Gorfinkel (L)

Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA.

Sharmila Raghunandan (S)

Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Emory University, Atlanta, GA, USA.

Benjamin Watkins (B)

Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Emory University, Atlanta, GA, USA.

Kyle Hebert (K)

Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.

Donna S Neuberg (DS)

Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.

Brandi Bratrude (B)

Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA.

Kayla Betz (K)

Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA.

Alison Yu (A)

Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA.

Sung W Choi (SW)

University of Michigan, Ann Arbor, MI, USA.

Jeffrey Davis (J)

BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada.

Christine Duncan (C)

Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA.

Roger Giller (R)

Center for Cancer and Blood Disorders, Children Hospital of Colorado, University of Colorado, Aurora, CO, USA.

Michael Grimley (M)

University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Andrew C Harris (AC)

Memorial Sloan Kettering Cancer Center, New York, NY, USA.

David Jacobsohn (D)

Children's National Health System, Washington, DC, USA.

Nahal Lalefar (N)

University of California San Francisco, UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA.

Nosha Farhadfar (N)

University of Florida, Gainesville, FL, USA.

Michael A Pulsipher (MA)

University of Utah, Primary Children's Hospital, Salt Lake City, UT, USA.

Shalini Shenoy (S)

Washington University School of Medicine, St Louis, MO, USA.

Aleksandra Petrovic (A)

Seattle Children's Hospital and Fred Hutch Cancer Center, Seattle, WA, USA.

Kirk R Schultz (KR)

BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada.

Gregory A Yanik (GA)

University of Michigan, Ann Arbor, MI, USA.

Bruce R Blazar (BR)

University of Minnesota, Department of Pediatrics, Division of Blood and Marrow Transplantation, Minneapolis, MN, USA.

John T Horan (JT)

Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA.

Amelia Langston (A)

Winship Cancer Institute, Emory University, Atlanta, GA, USA.

Leslie S Kean (LS)

Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA. Leslie.Kean@childrens.harvard.edu.

Muna Qayed (M)

Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Emory University, Atlanta, GA, USA. mqayed@emory.edu.

Classifications MeSH