Major-Monfried, Hannah and Renteria, Anne S. and Pawarode, Attaphol and Reddy, Pavan and Ayuk, Francis and Holler, Ernst and Efebera, Yvonne A. and Hogan, William J. and Woelfl, Matthias and Qayed, Muna and Hexner, Elizabeth O. and Wudhikarn, Kitsada and Ordemann, Rainer and Young, Rachel and Shah, Jay and Hartwell, Matthew J. and Chaudhry, Mohammed and Aziz, Mina and Etra, Aaron and Yanik, Gregory A. and Kroeger, Nicolaus and Weber, Daniela and Chen, Yi-Bin and Nakamura, Ryotaro and Roesler, Wolf and Kitko, Carrie L. and Harris, Andrew C. and Pulsipher, Michael and Reshef, Ran and Kowalyk, Steven and Morales, George and Torres, Ivan and Ozbek, Umut and Ferrara, James L. M. and Levine, John E. (2018) MAGIC biomarkers predict long-term outcomes for steroid-resistant acute GVHD. BLOOD, 131 (25). pp. 2846-2855. ISSN 0006-4971, 1528-0020
Full text not available from this repository. (Request a copy)Abstract
Acute graft-versus-host disease (GVHD) is treated with systemic corticosteroid immuno- suppression. Clinical response after 1 week of therapy often guides further treatment decisions, but long-term outcomes vary widely among centers, and more accurate predictive tests are urgently needed. We analyzed clinical data and blood samples taken 1 week after systemic treatment of GVHD from 507 patients from 17 centers of the Mount Sinai Acute GVHD International Consortium (MAGIC), dividing them into a test cohort (n = 236) and 2 validation cohorts separated in time (n = 142 and n = 129). Initial response to systemic steroids correlated with response at 4 weeks, 1-year nonrelapse mortality (NRM), and overall survival (OS). A previously validated algorithm of 2 MAGIC biomarkers (ST2 and REG3 alpha) consistently separated steroid-resistant patients into 2 groups with dramatically different NRM and OS (P < .001 for all 3 cohorts). High biomarker probability, resistance to steroids, and GVHD severity (Minnesota risk) were all significant predictors of NRM in multivariate analysis. A direct comparison of receiver operating characteristic curves showed that the area under the curve for biomarker probability (0.82) was significantly greater than that for steroid response (0.68, P = .004) and for Minnesota risk (0.72, P = .005). In conclusion, MAGIC biomarker probabilities generated after 1 week of systemic treatment of GVHD predict long-term outcomes in steroid-resistant GVHD better than clinical criteria and should prove useful in developing better treatment strategies.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | VERSUS-HOST-DISEASE; HEMATOPOIETIC-CELL TRANSPLANTATION; RISK; THERAPY; SURVIVAL; MARROW; BLOOD; ST2; MULTICENTER; MORTALITY; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Mar 2020 09:17 |
| Last Modified: | 09 Mar 2020 09:17 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14384 |
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