Disease progression, treatments, hospitalization, and clinical outcomes in acute GVHD: a multicenter chart review

Shernan G. Holtan; Jingbo Yu; Hannah K. Choe; Dilan Paranagama; Jackson Tang; Ahmad Naim; John Galvin; H. Joachim Deeg

doi:10.1038/s41409-022-01764-w

Disease progression, treatments, hospitalization, and clinical outcomes in acute GVHD: a multicenter chart review

Shernan G. Holtan, Jingbo Yu, Hannah K. Choe, Dilan Paranagama, Jackson Tang, Ahmad Naim, John Galvin, H. Joachim Deeg

Medicine - Hematology, Oncology, Transplant

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18 Scopus citations

Abstract

Acute graft-versus-host disease (GVHD) remains a barrier to successful allogeneic hematopoietic cell transplantation (HCT) outcomes. This multicenter, retrospective chart review describes disease progression, treatment patterns, hospitalizations, and clinical outcomes among 475 patients (≥12 years old) who developed grades II–IV acute GVHD after their first HCT (January 2014–June 2016). Median (interquartile range) age at HCT was 55 (44–63) years. From the date of acute GVHD diagnosis, 190 patients (40.0%) experienced progression to more severe disease and/or developed new organ involvement. Among 431 patients with grades II–IV acute GVHD at diagnosis, 73.1% received first-line systemic corticosteroids. During follow-up (median 524 days since acute GVHD diagnosis), 23.4% of patients had an increase in steroid dose and 44.4% were unable to taper below 10 mg/day. Over half of patients (54.9%) required ≥1 hospital readmission within 100 days post-HCT (≥2 readmissions in 22.3%); mean inpatient length of stay upon readmission was 27.5 days. Approximately half of patients (52.8%) died during follow-up; 1-year overall mortality from date of acute GVHD diagnosis and nonrelapse mortality rates were 35.2% and 25.5%, respectively. Overall, patients who developed acute GVHD following HCT had poor clinical outcomes, highlighting the unmet need for early and effective treatment strategies.

Original language	English (US)
Pages (from-to)	1581-1585
Number of pages	5
Journal	Bone marrow transplantation
Volume	57
Issue number	10
DOIs	https://doi.org/10.1038/s41409-022-01764-w
State	Published - Oct 2022

Bibliographical note

Funding Information:
We thank the following 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. Medical writing assistance was provided by Wendy van der Spuy, PhD, an employee of ICON (North Wales, PA), and was funded by Incyte Corporation.

Funding Information:
We thank the following 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. Medical writing assistance was provided by Wendy van der Spuy, PhD, an employee of ICON (North Wales, PA), and was funded by Incyte Corporation.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Limited.

PubMed: MeSH publication types

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

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title = "Disease progression, treatments, hospitalization, and clinical outcomes in acute GVHD: a multicenter chart review",

abstract = "Acute graft-versus-host disease (GVHD) remains a barrier to successful allogeneic hematopoietic cell transplantation (HCT) outcomes. This multicenter, retrospective chart review describes disease progression, treatment patterns, hospitalizations, and clinical outcomes among 475 patients (≥12 years old) who developed grades II–IV acute GVHD after their first HCT (January 2014–June 2016). Median (interquartile range) age at HCT was 55 (44–63) years. From the date of acute GVHD diagnosis, 190 patients (40.0%) experienced progression to more severe disease and/or developed new organ involvement. Among 431 patients with grades II–IV acute GVHD at diagnosis, 73.1% received first-line systemic corticosteroids. During follow-up (median 524 days since acute GVHD diagnosis), 23.4% of patients had an increase in steroid dose and 44.4% were unable to taper below 10 mg/day. Over half of patients (54.9%) required ≥1 hospital readmission within 100 days post-HCT (≥2 readmissions in 22.3%); mean inpatient length of stay upon readmission was 27.5 days. Approximately half of patients (52.8%) died during follow-up; 1-year overall mortality from date of acute GVHD diagnosis and nonrelapse mortality rates were 35.2% and 25.5%, respectively. Overall, patients who developed acute GVHD following HCT had poor clinical outcomes, highlighting the unmet need for early and effective treatment strategies.",

author = "Holtan, {Shernan G.} and Jingbo Yu and Choe, {Hannah K.} and Dilan Paranagama and Jackson Tang and Ahmad Naim and John Galvin and {Joachim Deeg}, H.",

note = "Funding Information: We thank the following 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. Medical writing assistance was provided by Wendy van der Spuy, PhD, an employee of ICON (North Wales, PA), and was funded by Incyte Corporation. Funding Information: We thank the following 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. Medical writing assistance was provided by Wendy van der Spuy, PhD, an employee of ICON (North Wales, PA), and was funded by Incyte Corporation. Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer Nature Limited.",

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AU - Tang, Jackson

AU - Naim, Ahmad

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Disease progression, treatments, hospitalization, and clinical outcomes in acute GVHD: a multicenter chart review

Abstract

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