Qayed, Muna and Kapoor, Urvi and Gillespie, Scott and Westbrook, Adrianna and Aguayo-Hiraldo, Paibel and Ayuk, Francis A. and Aziz, Mina and Baez, Janna and Choe, Hannah and Defilipp, Zachariah and Etra, Aaron and Grupp, Stephan A. and Hexner, Elizabeth and Holler, Ernst and Hogan, William J. and Kowalyk, Steven and Merli, Pietro and Morales, George and Nakamura, Ryotaro and Pulsipher, Michael A. and Schechter, Tal and Shah, Jay and Spyrou, Nikolaos and Srinagesh, Hrishikesh K. and Wolfl, Matthias and Yanik, Gregory and Young, Rachel and Kitko, Carrie L. and Ferrara, James L. M. and Levine, John E. (2024) A Validated Risk Strati fi cation That Incorporates MAGIC Biomarkers Predicts Long-Term Outcomes in Pediatric Patients with Acute GVHD. TRANSPLANTATION AND CELLULAR THERAPY, 30 (6). pp. 6030-60300000000000. ISSN 2666-6375, 2666-6367
Full text not available from this repository. (Request a copy)Abstract
Acute graft versus host disease (GVHD) is a common and serious complication of allogeneic hematopoietic cell transplantation (HCT) in children but overall clinical grade at onset only modestly predicts response to treatment and survival outcomes. Two tools to assess risk at initiation of treatment were recently developed. The Minnesota risk system stratifies children for risk of nonrelapse mortality (NRM) according to the pattern of GVHD target organ severity. The Mount Sinai Acute GVHD International Consortium (MAGIC) algorithm of 2 serum biomarkers (ST2 and REG3 alpha) predicts NRM in adult patients but has not been validated in a pediatric population. We aimed to develop and validate a system that stratifies children at the onset of GVHD for risk of 6-month NRM. We determined the MAGIC algorithm probabilities (MAPs) and Minnesota risk for a multicenter cohort of 315 pediatric patients who developed GVHD requiring treatment with systemic corticosteroids. MAPs created 3 risk groups with distinct outcomes at the start of treatment and were more accurate than Minnesota risk stratification for prediction of NRM (area under the receiver operating curve (AUC), .79 versus .62, P = .001). A novel model that combined Minnesota risk and biomarker scores created from a training cohort was more accurate than either biomarkers or clinical systems in a validation cohort (AUC .87) and stratified patients into 2 groups with highly different 6-month NRM (5% versus 38%, P < .001). In summary, we validated the MAP as a prognostic biomarker in pediatric patients with GVHD, and a novel risk stratification that combines Minnesota risk and biomarker risk performed best. Biomarker-based risk stratification can be used in clinical trials to develop more tailored approaches for children who require treatment for GVHD. (c) 2024 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | VERSUS-HOST-DISEASE; HEMATOPOIETIC-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; WORKING COMMITTEE; CHILDREN; ADOLESCENTS; BLOOD; CYCLOPHOSPHAMIDE; RECOMMENDATIONS; SOCIETY; Acute GVHD; Biomarkers; Validation; Pediatric |
| 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: | 18 Aug 2025 08:31 |
| Last Modified: | 18 Aug 2025 08:31 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65616 |
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