Rios, Carlos A. Ortega and Qayed, Muna and Etra, Aaron M. and Reshef, Ran and Newcomb, Richard and Yuhasz, Nicholas and Hexner, Elizabeth O. and Aguayo-Hiraldo, Paibel and Merli, Pietro and Hogan, William J. and Weber, Daniela and Kitko, Carrie L. and Ayuk, Francis and Eder, Matthias and Grupp, Stephan A. and Kraus, Sabrina and Sandhu, Karam and Ullrich, Evelyn and Vasova, Ingrid and Woelfl, Matthias and Baez, Janna and Beheshti, Rahnuma and Eng, Gilbert and Gleich, Sigrun and Katsivelos, Nikolaos and Kowalyk, Steven and Louloudis, Ioannis Evangelos and Morales, George and Spyrou, Nikolaos and Young, Rachel and Nakamura, Ryotaro and Levine, John E. and Ferrara, James L. M. and Akahoshi, Yu (2024) Differences in Acute Graft-Versus-Host Disease (GVHD) Severity and Its Outcomes Between Black and White Patients. TRANSPLANTATION AND CELLULAR THERAPY, 30 (11): 10610. ISSN 2666-6375, 2666-6367
Full text not available from this repository. (Request a copy)Abstract
Acute graft-versus-host disease (GVHD) is a significant complication following hematopoietic stem cell transplantation (HCT). Although recent advancements in GVHD prophylaxis have resulted in successful HCT across HLA barriers and expanded access to HCT for racial minorities, less is known about how race affects the severity and outcomes of acute GVHD. This study examines differences in the clinical course of acute GVHD and the prognostic value of GVHD biomarkers for Black and White recipients. We conducted a retrospective analysis of patients in the Mount Sinai Acute GVHD International Consortium (MAGIC) database who underwent HCT between 2014 and 2021 to describe the difference in clinical course of acute GVHD and significance of GVHD biomarkers between Black and White recipients. We used propensity score matching to generate a 1:3 matched cohort of 234 Black patients and 702 White patients with similar baseline characteristics. In the first year after HCT Black patients experienced a higher cumulative incidence of grade III-IV acute GVHD (17% versus 12%, P = 0.050), higher nonrelapse mortality (NRM; 18% versus 12%, P = .009), and lower overall survival that trended toward statistical significance (73% versus 79%, P = .071) compared to White patients. The difference in NRM in the first year was even greater among Black patients who developed GVHD than White patients (24% versus 14%, P = .041). The distribution of low, intermediate, and high MAGIC biomarker scores at the time of treatment was similar across racial groups (P = .847), however, Black patients with high biomarker scores experienced significantly worse NRM than White patients (71% versus 32%, P = .010). Our data indicate that Black patients are at a higher risk of NRM following HCT, primarily from a higher incidence of severe GVHD. Serum biomarkers at treatment initiation can stratify patients for risk of NRM across races, however Black patients with high biomarker scores had a significantly greater NRM risk. These results suggest a need for strategies that mitigate the higher risk for poor GVHD outcomes among Black patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HEMATOPOIETIC-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; PHASE-II TRIAL; SURVIVAL; BLOOD; RACE; TRENDS; SCORE; RISK; MULTICENTER; Acute GVHD; Race; Biomarker |
| 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 08:27 |
| Last Modified: | 18 Aug 2025 08:27 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65628 |
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