| Autor: |
Andrzej Frankiewicz, Christophe Peczynski, Sebastian Giebel, Alenca Harrington, Gerard Socié, Dietger Niederwieser, Christoph Scheid, Martin Bornhäuser, Nicolaus Kröger, Ahmet Elmaagacli, Boris Afanasyev, Peter Dreger, Claudia Rössig, Didier Blaise, Christian Kratz, Ibrahim Yakoub-Agha, Bernhard Kremens, Charlotte Marie Niemeyer, Gerald Wulf, Igor Blau, Olaf Penack, Hildegard Greinix, Grzegorz W. Basak |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
Frontiers in Immunology, Vol 11 (2020) |
| Druh dokumentu: |
article |
| ISSN: |
1664-3224 |
| DOI: |
10.3389/fimmu.2020.01537 |
| Popis: |
Acute graft-vs.-host disease (aGvHD) is one of the most frequent causes of transplant-related mortality (TRM) after allogeneic hematopoietic cell transplantation (alloHCT). Its treatment is complex and costly. The aim of this study was to retrospectively analyze the impact of country-specific socioeconomic factors on outcome of patients who experience severe aGvHD. Adults with hematological malignancies receiving alloHCT from either HLA-matched siblings (n = 1,328) or unrelated donors (n = 2,824) developing grade 3 or 4 aGvHD were included. In univariate analysis, the probability of TRM at 2 years was increased for countries with lower current Health Care Expenditure (HCE, p = 0.04), lower HCE as % of Gross Domestic Product per capita (p = 0.003) and lower values of the Human Development Index (p = 0.02). In a multivariate model, the risk of TRM was most strongly predicted by current HCE (HR = 0.76, p = 0.006). HCE >median was also associated with reduced risk of the overall mortality (HR 0.73, p = 0.0006) and reduced risk of treatment failure (either relapse or TRM; HR 0.77, p = 0.004). We conclude that country-specific socioeconomic factors, in particular current HCE, are strongly associated with survival of patients who experience severe aGvHD. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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