High incidence of thromboembolism in patients with chronic GVHD: association with severity of GVHD and donor-recipient ABO blood group

Najla El Jurdi; Heba Elhusseini; Joan D Beckman; Todd E. DeFor; Grigori Okoev; John Rogosheske; Aleksandr Lazaryan; Kristen Weiler; Veronika Bachanova; Brian C. Betts; Bruce R. Blazar; Claudio G Brunstein; Fiona He; Shernan G Holtan; Murali Janakiram; Radhika Gangaraju; Joseph Maakaron; Margaret L. MacMillan; Armin Rashidi; Erica D Warlick; Smita Bhatia; Gregory Vercellotti; Daniel J Weisdorf; Mukta Arora

doi:10.1038/s41408-021-00488-2

High incidence of thromboembolism in patients with chronic GVHD: association with severity of GVHD and donor-recipient ABO blood group

Najla El Jurdi, Heba Elhusseini, Joan D Beckman, Todd E. DeFor, Grigori Okoev, John Rogosheske, Aleksandr Lazaryan, Kristen Weiler, Veronika Bachanova, Brian C. Betts, Bruce R. Blazar, Claudio G Brunstein, Fiona He, Shernan G Holtan, Murali Janakiram, Radhika Gangaraju, Joseph Maakaron, Margaret L. MacMillan, Armin Rashidi, Erica D WarlickSmita Bhatia, Gregory Vercellotti, Daniel J Weisdorf, Mukta Arora

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation (HCT) is associated with systemic inflammation and endothelial dysfunction, increasing risk for thromboembolic events (TEE). In 145 adult recipients who developed cGVHD after a matched sibling or umbilical cord blood donor HCT from 2010 to 2018, 32(22%) developed at least 1 TEE event, and 14(10%) developed 2 TEE events. The 5-year cumulative incidence of TEE was 22% (95% CI, 15–29%) with a median time from cGVHD to TEE of 234 days (range, 12–2050). Median time to the development of LE DVT or PE was 107 (range, 12–1925) compared to 450 days (range, 158–1300) for UE DVT. Cumulative incidence of TEE was 9% (95% CI, 0–20%), 17% (95% CI, 9–25%), and 38% (95% CI, 22–55%) in those with mild, moderate, and severe GVHD, respectively. Higher risk for TEE was associated with cGVHD severity (hazard ratio [HR] 4.9, [95% CI, 1.1–22.0]; p = 0.03), non-O-donor to recipient ABO match compared to O-donor to O-recipient match (HR 2.7, [95% CI, 1.0–7.5]; p = 0.053), and personal history of coronary artery disease (HR 2.4, [95% CI, 1.1–5.3]; p = 0.03). TEE was not associated with 2-year non-relapse mortality or 5-year overall survival.

Original language	English (US)
Article number	96
Journal	Blood cancer journal
Volume	11
Issue number	5
DOIs	https://doi.org/10.1038/s41408-021-00488-2
State	Published - May 18 2021

Bibliographical note

Funding Information:
D.J.W.—research support from Incyte. B.R.B.—founder of Tmunity Therapeutics, advisory board member for Kadmon Pharmaceuticals, Magenta Therapeutics, and BlueRock Therapeutics and receives research funding from BlueRock Therapeutics. S.G.H.—consultant for Incyte. The remaining authors declare no competing interests.

Funding Information:
This research was supported by NIH grant P30 CA77598 utilizing the Biostatistics Core of the Masonic Cancer Center, University of Minnesota and the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR002494. We would like to acknowledge Michael Franklin, MS, for assistance in editing this manuscript.

Publisher Copyright:
© 2021, The Author(s).

PubMed: MeSH publication types

Journal Article
Research Support, N.I.H., Extramural

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1038/s41408-021-00488-2

Find It

Find It at U of M Libraries

Cite this

El Jurdi, N., Elhusseini, H., Beckman, J. D., DeFor, T. E., Okoev, G., Rogosheske, J., Lazaryan, A., Weiler, K., Bachanova, V., Betts, B. C., Blazar, B. R., Brunstein, C. G., He, F., Holtan, S. G., Janakiram, M., Gangaraju, R., Maakaron, J., MacMillan, M. L., Rashidi, A., ... Arora, M. (2021). High incidence of thromboembolism in patients with chronic GVHD: association with severity of GVHD and donor-recipient ABO blood group. Blood cancer journal, 11(5), Article 96. https://doi.org/10.1038/s41408-021-00488-2

El Jurdi, N, Elhusseini, H, Beckman, JD , DeFor, TE, Okoev, G, Rogosheske, J, Lazaryan, A, Weiler, K, Bachanova, V, Betts, BC, Blazar, BR, Brunstein, CG, He, F , Holtan, SG, Janakiram, M, Gangaraju, R, Maakaron, J , MacMillan, ML , Rashidi, A, Warlick, ED, Bhatia, S, Vercellotti, G , Weisdorf, DJ & Arora, M 2021, 'High incidence of thromboembolism in patients with chronic GVHD: association with severity of GVHD and donor-recipient ABO blood group', Blood cancer journal, vol. 11, no. 5, 96. https://doi.org/10.1038/s41408-021-00488-2

@article{ba914a0acad6469b8fc8495dd38f57ee,

title = "High incidence of thromboembolism in patients with chronic GVHD: association with severity of GVHD and donor-recipient ABO blood group",

abstract = "Chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation (HCT) is associated with systemic inflammation and endothelial dysfunction, increasing risk for thromboembolic events (TEE). In 145 adult recipients who developed cGVHD after a matched sibling or umbilical cord blood donor HCT from 2010 to 2018, 32(22%) developed at least 1 TEE event, and 14(10%) developed 2 TEE events. The 5-year cumulative incidence of TEE was 22% (95% CI, 15–29%) with a median time from cGVHD to TEE of 234 days (range, 12–2050). Median time to the development of LE DVT or PE was 107 (range, 12–1925) compared to 450 days (range, 158–1300) for UE DVT. Cumulative incidence of TEE was 9% (95% CI, 0–20%), 17% (95% CI, 9–25%), and 38% (95% CI, 22–55%) in those with mild, moderate, and severe GVHD, respectively. Higher risk for TEE was associated with cGVHD severity (hazard ratio [HR] 4.9, [95% CI, 1.1–22.0]; p = 0.03), non-O-donor to recipient ABO match compared to O-donor to O-recipient match (HR 2.7, [95% CI, 1.0–7.5]; p = 0.053), and personal history of coronary artery disease (HR 2.4, [95% CI, 1.1–5.3]; p = 0.03). TEE was not associated with 2-year non-relapse mortality or 5-year overall survival.",

author = "{El Jurdi}, Najla and Heba Elhusseini and Beckman, {Joan D} and DeFor, {Todd E.} and Grigori Okoev and John Rogosheske and Aleksandr Lazaryan and Kristen Weiler and Veronika Bachanova and Betts, {Brian C.} and Blazar, {Bruce R.} and Brunstein, {Claudio G} and Fiona He and Holtan, {Shernan G} and Murali Janakiram and Radhika Gangaraju and Joseph Maakaron and MacMillan, {Margaret L.} and Armin Rashidi and Warlick, {Erica D} and Smita Bhatia and Gregory Vercellotti and Weisdorf, {Daniel J} and Mukta Arora",

note = "Funding Information: D.J.W.—research support from Incyte. B.R.B.—founder of Tmunity Therapeutics, advisory board member for Kadmon Pharmaceuticals, Magenta Therapeutics, and BlueRock Therapeutics and receives research funding from BlueRock Therapeutics. S.G.H.—consultant for Incyte. The remaining authors declare no competing interests. Funding Information: This research was supported by NIH grant P30 CA77598 utilizing the Biostatistics Core of the Masonic Cancer Center, University of Minnesota and the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR002494. We would like to acknowledge Michael Franklin, MS, for assistance in editing this manuscript. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = may,

day = "18",

doi = "10.1038/s41408-021-00488-2",

language = "English (US)",

volume = "11",

journal = "Blood cancer journal",

issn = "2044-5385",

publisher = "Nature Publishing Group",

number = "5",

}

TY - JOUR

T1 - High incidence of thromboembolism in patients with chronic GVHD

T2 - association with severity of GVHD and donor-recipient ABO blood group

AU - El Jurdi, Najla

AU - Elhusseini, Heba

AU - Beckman, Joan D

AU - DeFor, Todd E.

AU - Okoev, Grigori

AU - Rogosheske, John

AU - Lazaryan, Aleksandr

AU - Weiler, Kristen

AU - Bachanova, Veronika

AU - Betts, Brian C.

AU - Blazar, Bruce R.

AU - Brunstein, Claudio G

AU - He, Fiona

AU - Holtan, Shernan G

AU - Janakiram, Murali

AU - Gangaraju, Radhika

AU - Maakaron, Joseph

AU - MacMillan, Margaret L.

AU - Rashidi, Armin

AU - Warlick, Erica D

AU - Bhatia, Smita

AU - Vercellotti, Gregory

AU - Weisdorf, Daniel J

AU - Arora, Mukta

N1 - Funding Information: D.J.W.—research support from Incyte. B.R.B.—founder of Tmunity Therapeutics, advisory board member for Kadmon Pharmaceuticals, Magenta Therapeutics, and BlueRock Therapeutics and receives research funding from BlueRock Therapeutics. S.G.H.—consultant for Incyte. The remaining authors declare no competing interests. Funding Information: This research was supported by NIH grant P30 CA77598 utilizing the Biostatistics Core of the Masonic Cancer Center, University of Minnesota and the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR002494. We would like to acknowledge Michael Franklin, MS, for assistance in editing this manuscript. Publisher Copyright: © 2021, The Author(s).

PY - 2021/5/18

Y1 - 2021/5/18

N2 - Chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation (HCT) is associated with systemic inflammation and endothelial dysfunction, increasing risk for thromboembolic events (TEE). In 145 adult recipients who developed cGVHD after a matched sibling or umbilical cord blood donor HCT from 2010 to 2018, 32(22%) developed at least 1 TEE event, and 14(10%) developed 2 TEE events. The 5-year cumulative incidence of TEE was 22% (95% CI, 15–29%) with a median time from cGVHD to TEE of 234 days (range, 12–2050). Median time to the development of LE DVT or PE was 107 (range, 12–1925) compared to 450 days (range, 158–1300) for UE DVT. Cumulative incidence of TEE was 9% (95% CI, 0–20%), 17% (95% CI, 9–25%), and 38% (95% CI, 22–55%) in those with mild, moderate, and severe GVHD, respectively. Higher risk for TEE was associated with cGVHD severity (hazard ratio [HR] 4.9, [95% CI, 1.1–22.0]; p = 0.03), non-O-donor to recipient ABO match compared to O-donor to O-recipient match (HR 2.7, [95% CI, 1.0–7.5]; p = 0.053), and personal history of coronary artery disease (HR 2.4, [95% CI, 1.1–5.3]; p = 0.03). TEE was not associated with 2-year non-relapse mortality or 5-year overall survival.

AB - Chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation (HCT) is associated with systemic inflammation and endothelial dysfunction, increasing risk for thromboembolic events (TEE). In 145 adult recipients who developed cGVHD after a matched sibling or umbilical cord blood donor HCT from 2010 to 2018, 32(22%) developed at least 1 TEE event, and 14(10%) developed 2 TEE events. The 5-year cumulative incidence of TEE was 22% (95% CI, 15–29%) with a median time from cGVHD to TEE of 234 days (range, 12–2050). Median time to the development of LE DVT or PE was 107 (range, 12–1925) compared to 450 days (range, 158–1300) for UE DVT. Cumulative incidence of TEE was 9% (95% CI, 0–20%), 17% (95% CI, 9–25%), and 38% (95% CI, 22–55%) in those with mild, moderate, and severe GVHD, respectively. Higher risk for TEE was associated with cGVHD severity (hazard ratio [HR] 4.9, [95% CI, 1.1–22.0]; p = 0.03), non-O-donor to recipient ABO match compared to O-donor to O-recipient match (HR 2.7, [95% CI, 1.0–7.5]; p = 0.053), and personal history of coronary artery disease (HR 2.4, [95% CI, 1.1–5.3]; p = 0.03). TEE was not associated with 2-year non-relapse mortality or 5-year overall survival.

UR - http://www.scopus.com/inward/record.url?scp=85106152044&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85106152044&partnerID=8YFLogxK

U2 - 10.1038/s41408-021-00488-2

DO - 10.1038/s41408-021-00488-2

M3 - Article

C2 - 34006823

AN - SCOPUS:85106152044

SN - 2044-5385

VL - 11

JO - Blood cancer journal

JF - Blood cancer journal

IS - 5

M1 - 96

ER -

High incidence of thromboembolism in patients with chronic GVHD: association with severity of GVHD and donor-recipient ABO blood group

Abstract

Bibliographical note

PubMed: MeSH publication types

UN SDGs

Publisher link

Find It

Other files and links

Fingerprint

Cite this