Akahoshi, Yu and Spyrou, Nikolaos and Hogan, William J. and Ayuk, Francis and DeFilipp, Zachariah and Weber, Daniela and Choe, Hannah K. and Hexner, Elizabeth O. and Roesler, Wolf and Etra, Aaron M. and Sandhu, Karamjeet and Yanik, Gregory A. and Chanswangphuwana, Chantiya and Kitko, Carrie L. and Reshef, Ran and Kraus, Sabrina and Woelfl, Matthias and Eder, Matthias and Bertrand, Hannah and Qayed, Muna and Merli, Pietro and Grupp, Stephan A. and Aguayo-Hiraldo, Paibel and Schechter, Tal and Ullrich, Evelyn and Baez, Janna and Beheshti, Rahnuma and Gleich, Sigrun and Kowalyk, Steven and Morales, George and Young, Rachel and Kwon, Deukwoo and Nakamura, Ryotaro and Levine, John E. and Ferrara, James L. M. and Chen, Yi-Bin (2023) Incidence, clinical presentation, risk factors, outcomes, and biomarkers in de novo late acute GVHD. BLOOD ADVANCES, 7 (16). pp. 4479-4491. ISSN 2473-9529, 2473-9537
Full text not available from this repository. (Request a copy)Abstract
Late acute graft-versus-host disease (GVHD) is defined as de novo acute GVHD presenting beyond 100 days after allogeneic hematopoietic cell transplantation (HCT) without manifestations of chronic GVHD. Data are limited regarding its characteristics, clinical course, and risk factors because of underrecognition and changes in classification. We evaluated 3542 consecutive adult recipients of first HCTs at 24 Mount Sinai Acute GVHD International Consortium (MAGIC) centers between January 2014 and August 2021 to better describe the clinical evolution and outcomes of late acute GVHD. The cumulative incidence of classic acute GVHD that required systemic treatment was 35.2%, and an additional 5.7% of patients required treatment for late acute GVHD. At the onset of symptoms, late acute GVHD was more severe than classic acute GVHD based on both clinical and MAGIC algorithm probability biomarker parameters and showed a lower overall response rate on day 28. Both clinical and biomarker grading at the time of treatment stratified the risk of nonrelapse mortality (NRM) in patients with classic and late acute GVHD, respectively, but long-term NRM and overall survival did not differ between patients with classic and late acute GVHD. Advanced age, female-to-male sex mismatch, and the use of reduced intensity conditioning were associated with the development of late acute GVHD, whereas the use of posttransplant cyclophosphamide-based GVHD prevention was protective mainly because of shifts in GVHD timing. Because overall outcomes were comparable, our findings, although not definitive, suggest that similar treatment strategies, including eligibility for clinical trials, based solely on clinical presentation at onset are appropriate.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | VERSUS-HOST-DISEASE; CONSENSUS DEVELOPMENT PROJECT; CHRONIC GRAFT; DOSE PREDNISONE; INITIAL THERAPY; SURVIVAL; CRITERIA; DIAGNOSIS; TRANSPLANTATION; CLASSIFICATION; |
| 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: | 30 Jan 2024 07:25 |
| Last Modified: | 30 Jan 2024 07:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60954 |
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