Holtan, Shernan G. and Khera, Nandita and Levine, John E. and Chai, Xiaoyu and Storer, Barry and Liu, Hien D. and Inamoto, Yoshihiro and Chen, George L. and Mayer, Sebastian and Arora, Mukta and Palmer, Jeanne and Flowers, Mary E. D. and Cutler, Corey S. and Lukez, Alexander and Arai, Sally and Lazaryan, Aleksandr and Newell, Laura F. and Krupski, Christa and Jagasia, Madan H. and Pusic, Iskra and Wood, William and Renteria, Anne S. and Yanik, Gregory and Hogan, William J. and Hexner, Elizabeth and Ayuk, Francis and Holler, Ernst and Watanaboonyongcharoen, Phandee and Efebera, Yvonne A. and Ferrara, James L. M. and Panoskaltsis-Mortari, Angela and Weisdorf, Daniel and Lee, Stephanie J. and Pidala, Joseph (2016) Late acute graft-versus-host disease: a prospective analysis of clinical outcomes and circulating angiogenic factors. BLOOD, 128 (19). pp. 2350-2358. ISSN 0006-4971, 1528-0020
Full text not available from this repository. (Request a copy)Abstract
Late acute (LA) graft-versus-host disease (GVHD) is persistent, recurrent, or new-onset acute GVHD symptoms occurring > 100 days after allogeneic hematopoietic cell transplantation (HCT). The aim of this analysis is to describe the onset, course, morbidity, and mortality of and examine angiogenic factors associated with LA GVHD. A prospective cohort of patients (n 5 909) was enrolled as part of an observational study within the Chronic GVHD Consortium. Eighty-three patients (11%) developed LA GVHD at a median of 160 (interquartile range, 128-204) days after HCT. Although 51 out of 83 (61%) achieved complete or partial response to initial therapy by 28 days, median failure-free survival was only 7.1 months (95% confidence interval, 3.4-19.1 months), and estimated overall survival (OS) at 2 years was 56%. Given recently described alterations of circulating angiogenic factors in classic acute GVHD, we examined whether alterations in such factors could be identified in LA GVHD. We first tested cases (n=55) and controls (n=50) from the Chronic GVHD Consortium and then validated the findings in 37 cases from Mount Sinai Acute GVHD International Consortium. Plasma amphiregulin (AREG; an epidermal growth factor [EGF] receptor ligand) was elevated, and an AREG/EGF ratio at or above the median was associated with inferior OS and increased nonrelapse mortality in both cohorts. Elevation of AREG was detected in classic acute GVHD, but not chronic GVHD. These prospective data characterize the clinical course of LA GVHD and demonstrate alterations in angiogenic factors that make LA GVHD biologically distinct from chronic GVHD.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HEMATOPOIETIC-CELL TRANSPLANTATION; NIH CONSENSUS CRITERIA; FAILURE-FREE SURVIVAL; EPIDERMAL-GROWTH-FACTOR; WORKING GROUP-REPORT; REDUCED INTENSITY; DEVELOPMENT PROJECT; SYSTEMIC TREATMENT; TISSUE-REPAIR; CHRONIC GVHD; |
| 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: | 12 Apr 2019 10:43 |
| Last Modified: | 12 Apr 2019 10:43 |
| URI: | https://pred.uni-regensburg.de/id/eprint/3955 |
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