Akahoshi, Yu and Portelli, Joseph and Katsivelos, Nikolaos and Louloudis, Ioannis E. and Aguayo-Hiraldo, Paibel and Ayuk, Francis and Chanswangphuwana, Chantiya and Choe, Hannah K. and Eder, Matthias and Etra, Aaron M. and Hexner, Elizabeth O. and Kitko, Carrie L. and Kraus, Sabrina and Merli, Pietro and Olson, Timothy S. and Pasic, Ivan and Qayed, Muna and Reshef, Ran and Schechter, Tal and Marx, Julia and Ullrich, Evelyn and Vasova, Ingrid and Weber, Daniela and Wolfl, Matthias and Zeiser, Robert and Baez, Janna and Eng, Gilbert and Gleich, Sigrun and Kowalyk, Steven and Morales, George and Spyrou, Nikolaos and Young, Rachel and Defilipp, Zachariah and Hogan, William J. and Nakamura, Ryotaro and Levine, John E. and Ferrara, James L. M. (2025) The MAGIC composite response: a novel end point integrating clinical and biomarker parameters for acute GVHD. BLOOD ADVANCES, 9 (22). pp. 5763-5773. ISSN 2473-9529, 2473-9537
Full text not available from this repository. (Request a copy)Abstract
Changes in the clinical symptoms of acute graft-versus-host disease (GVHD) are currently used to assess treatment responses. The Mount Sinai Acute GVHD International Consortium (MAGIC) consortium has recently revealed that the integration of serum biomarkers with clinical symptoms at the onset of treatment in a MAGIC composite score (MCS) more accurately predicts treatment response and 6-month nonrelapse mortality (NRM) than clinical symptoms alone. In this study, we evaluated whether the integration of serum biomarkers and clinical symptoms on day 28 (D28) would also better predict NRM than clinical response only (CRO). We analyzed data from 1135 patients receiving systemic treatment for acute GVHD and created a fourth MCS category for patients with complete resolution of symptoms and low-risk clinical biomarkers on D28. Using a classification and regression tree model with 6-month NRM as the end point, we identified status of MCS 0 or MCS 1 at D28 as responses, which we termed the MAGIC composite response (MCR). In the validation cohort (n = 309), MCR more accurately predicted 6-month NRM than CRO (area under the curve: 0.77 vs 0.69; P = .014) and demonstrated higher negative and positive predictive values. MCR correctly reclassified both clinical nonresponders and responders: 28 of 213 clinical responders (13%) became nonresponders with fivefold higher NRM (34.3% vs 6.8%, P < .001) and a larger group (29/96, 30%) of clinical nonresponders became responders with sixfold lower NRM (7.6% vs 50.7%, P < .001). These findings support the use of MCR as a superior surrogate end point for long-term GVHD control and survival in future clinical trials.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | VERSUS-HOST-DISEASE; RISK; SURVIVAL; THERAPY; |
| 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: | 24 Mar 2026 13:22 |
| Last Modified: | 24 Mar 2026 13:22 |
| URI: | https://pred.uni-regensburg.de/id/eprint/68049 |
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