Abstract
Acute graft-versus-host disease (GVHD) is a significant cause of morbidity and mortality following allogeneic hematopoietic cell transplantation (HCT). This analysis of 168 patients (mean age, 54.8 years) from a multicenter, retrospective chart review describes the clinical course, treatment patterns, hospitalizations, and clinical outcomes of patients aged ≥12 years who developed grades II–IV acute GVHD after their first allogeneic HCT (January 1, 2014, to June 30, 2016) and were refractory to or dependent on corticosteroids. Between diagnosis and maximum grade (median, 6.0 days), 53.6% of patients had new organ involvement, particularly lower gastrointestinal tract acute GVHD, or an increase in acute GVHD grade. Eighty-nine patients (53.0%) received additional systemic GVHD therapy (after systemic corticosteroids) within a median of 21.0 days. Hospital readmission(s) was required for 56.5% of patients within 100 days post-HCT (mean inpatient length of readmission stay, 49.5 days); 24.4% had ≥2 readmissions within 100 days post-HCT. From the date of acute GVHD diagnosis, 70.2% of patients died at a median (interquartile range) of 117.5 (49–258) days. In summary, steroid-refractory and steroid-dependent acute GVHD is associated with a rapidly worsening clinical course that leads to high readmission and mortality rates, emphasizing the need for effective and tolerable therapies.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1399-1404 |
| Number of pages | 6 |
| Journal | Bone marrow transplantation |
| Volume | 57 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2022 |
Bibliographical note
Funding Information:The authors thank the 11 centers/institutions that provided data for the study: Atrium Health, Cleveland Medical Center, Duke University, Fred Hutchinson Cancer Research Center, Medical College of Wisconsin, Ohio State University, University of Florida, University of Illinois, University of Minnesota, University of North Carolina, and University of Pennsylvania. The authors also thank Becky Hanna of Asclepius Analytics for her contributions to study design and data analysis. Writing assistance was provided by Wendy van der Spuy, PhD, an employee of ICON (North Wales, PA), and was funded by Incyte Corporation (Wilmington, DE).
Funding Information:
The authors thank the 11 centers/institutions that provided data for the study: Atrium Health, Cleveland Medical Center, Duke University, Fred Hutchinson Cancer Research Center, Medical College of Wisconsin, Ohio State University, University of Florida, University of Illinois, University of Minnesota, University of North Carolina, and University of Pennsylvania. The authors also thank Becky Hanna of Asclepius Analytics for her contributions to study design and data analysis. Writing assistance was provided by Wendy van der Spuy, PhD, an employee of ICON (North Wales, PA), and was funded by Incyte Corporation (Wilmington, DE).
Publisher Copyright:
© 2022, The Author(s).