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

Autor: Gorfinkel L; Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA., Raghunandan S; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Emory University, Atlanta, GA, USA., Watkins B; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Emory University, Atlanta, GA, USA., Hebert K; Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA., Neuberg DS; Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA., Bratrude B; Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA., Betz K; Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA., Yu A; Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA., Choi SW; University of Michigan, Ann Arbor, MI, USA., Davis J; BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada., Duncan C; Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA., Giller R; Center for Cancer and Blood Disorders, Children Hospital of Colorado, University of Colorado, Aurora, CO, USA., Grimley M; University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA., Harris AC; Memorial Sloan Kettering Cancer Center, New York, NY, USA., Jacobsohn D; Children's National Health System, Washington, DC, USA., Lalefar N; University of California San Francisco, UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA., Farhadfar N; University of Florida, Gainesville, FL, USA., Pulsipher MA; University of Utah, Primary Children's Hospital, Salt Lake City, UT, USA., Shenoy S; Washington University School of Medicine, St Louis, MO, USA., Petrovic A; Seattle Children's Hospital and Fred Hutch Cancer Center, Seattle, WA, USA., Schultz KR; BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada., Yanik GA; University of Michigan, Ann Arbor, MI, USA., Blazar BR; University of Minnesota, Department of Pediatrics, Division of Blood and Marrow Transplantation, Minneapolis, MN, USA., Horan JT; Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA., Langston A; Winship Cancer Institute, Emory University, Atlanta, GA, USA., Kean LS; Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA. Leslie.Kean@childrens.harvard.edu., Qayed M; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Emory University, Atlanta, GA, USA. mqayed@emory.edu.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2024 May; Vol. 59 (5), pp. 680-687. Date of Electronic Publication: 2024 Feb 21.
DOI: 10.1038/s41409-024-02245-y
Abstrakt: 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.
(© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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