AI Article Synopsis

  • - Chronic graft-versus-host disease (cGVHD) poses significant challenges for patients who have undergone allogeneic hematopoietic cell transplantation (HCT) and can negatively impact long-term success.
  • - In a study of 784 patients who received HCT, 44% developed acute GVHD (aGVHD), with varying responses: steroid-sensitive (SS), steroid-dependent (SD), and steroid-resistant (SR), leading to a 25% incidence of cGVHD after 3 years.
  • - The research found that both SD and SR responses to aGVHD were strong risk factors for developing cGVHD, suggesting that understanding previous aGVHD treatment responses can help predict the severity and outcomes of c

Article Abstract

Chronic graft-versus-host disease (cGVHD) is a major limitation to the long-term success of allogeneic hematopoietic cell transplantation (HCT). Our prior study of acute GVHD (aGVHD) defined distinct treatment-response groups based on the response to first-line corticosteroids: steroid-sensitive (SS), steroid-resistant (SR), and steroid-dependent (SD) aGVHDs. We conducted a retrospective, single-institution, cohort study to assess the incidence, risk factors, and clinical outcomes of patients with cGVHD after a previous diagnosis of SS, SD, or SR aGVHD, compared with those with no history of aGVHD. Among 784 consecutive adult and pediatric recipients of HCT for hematologic malignancies between 2008 and 2016, 347 (44%) developed aGVHD, with 13% SS, 12% SD, and 19% SR aGVHD. The 3-year cumulative incidence of cGVHD was 25%. Among those with cGVHD, 39% had no prior aGVHD diagnosis, whereas among those with a prior aGVHD diagnosis, 16% had SS, 24% had SD, and 21% had SR aGVHD. Mild or moderate cGVHD was highest among those with preceding SD aGVHD, whereas severe cGVHD was most frequent among those with previous SR aGVHD. We identified SD and SR aGVHDs as significant independent risk factors for the development of cGVHD after allogeneic HCT, whereas SS aGVHD was not a risk factor. Our study demonstrates that cGVHD after SD aGVHD did not have an intermediate prognosis between SR and SS groups as hypothesized; rather, cGVHD after both SD and SR aGVHD have similar prognoses. Our findings suggest that previous aGVHD response states are important predictors of cGVHD severity and outcomes.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365934PMC
http://dx.doi.org/10.1182/bloodadvances.2022009505DOI Listing

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