DeFilipp, Zachariah and Kim, Haesook T. and Spyrou, Nikolaos and Katsivelos, Nikolaos and Kowalyk, Steven and Eng, Gilbert and Kasikis, Stelios and Beheshti, Rahnuma and Baez, Janna and Akahoshi, Yu and Ayuk, Francis and Choe, Hannah and Etra, Aaron and Grupp, Stephan A. and Hexner, Elizabeth O. and Hogan, William J. and Kitko, Carrie L. and Qayed, Muna and Reshef, Ran and Vasova, Ingrid and Zeiser, Robert and Young, Rachel and Holler, Ernst and Ferrara, James L. M. and Nakamura, Ryotaro and Levine, John E. and Chen, Yi-Bin (2024) The MAGIC algorithm probability predicts treatment response and long-term outcomes to second-line therapy for acute GVHD. BLOOD ADVANCES, 8 (13). pp. 3488-3496. ISSN 2473-9529, 2473-9537
Full text not available from this repository. (Request a copy)Abstract
The significance of biomarkers in second-line treatment for acute graft-versus-host disease (GVHD) has not been well characterized. We analyzed clinical data and serum samples at the initiation of second-line systemic treatment of acute GVHD from 167 patients from 17 centers of the Mount Sinai Acute GVHD International Consortium (MAGIC) between 2016 and 2021. Sixty-two patients received ruxolitinib-based therapy, whereas 102 received other systemic agents. In agreement with prospective trials, ruxolitinib resulted in a higher day 28 (D28) overall response Frate than nonruxolitinib therapies (55% vs 31%, P = .003) and patients who received ruxolitinib had significantly lower nonrelapse mortality (NRM) than those who received nonruxolitinib therapies (point estimates at 2-year: 35% vs 61%, P = .002). Biomarker analyses demonstrated that the benefit from ruxolitinib was observed only in patients with low MAGIC algorithm probabilities (MAPs) at the start of second-line treatment. Among patients with a low MAP, those who received ruxolitinib experienced significantly lower NRM than those who received nonruxolitinib therapies (point estimates at 2-year: 12% vs 41%, P = .016). However, patients with high MAP experienced high NRM regardless of treatment with ruxolitinib or nonruxolitinib therapies (point estimates at 2-year: 67% vs 80%, P = .65). A landmark analysis demonstrated that the relationship between the D28 response and NRM largely depends on the MAP level at the initiation of second-line therapy. In conclusion, MAP measured at second-line systemic treatment for acute GVHD predicts treatment response and NRM. The outcomes of patients with high MAP are poor regardless of treatment choice, and ruxolitinib appears to primarily benefit patients with low MAP.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | VERSUS-HOST-DISEASE; BIOMARKERS; RUXOLITINIB; SCORE |
| 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: | 22 Jan 2026 07:38 |
| Last Modified: | 22 Jan 2026 07:38 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65457 |
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