TY - JOUR
T1 - Overlap chronic GVHD is associated with adverse survival outcomes compared to classic chronic GVHD
AU - Gorfinkel, Lev
AU - Raghunandan, Sharmila
AU - Watkins, Benjamin
AU - Hebert, Kyle
AU - Neuberg, Donna S.
AU - Bratrude, Brandi
AU - Betz, Kayla
AU - Yu, Alison
AU - Choi, Sung W.
AU - Davis, Jeffrey
AU - Duncan, Christine
AU - Giller, Roger
AU - Grimley, Michael
AU - Harris, Andrew C.
AU - Jacobsohn, David
AU - Lalefar, Nahal
AU - Farhadfar, Nosha
AU - Pulsipher, Michael A.
AU - Shenoy, Shalini
AU - Petrovic, Aleksandra
AU - Schultz, Kirk R.
AU - Yanik, Gregory A.
AU - Blazar, Bruce R.
AU - Horan, John T.
AU - Langston, Amelia
AU - Kean, Leslie S.
AU - Qayed, Muna
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature Limited 2024.
PY - 2024
Y1 - 2024
N2 - Chronic graft-versus-host-disease (cGVHD) is divided into two subtypes: classic (absence of acute GVHD features) and overlap cGVHD (‘ocGVHD’), in which both chronic and acute GVHD clinical features are present simultaneously. While worse outcomes with ocGVHD have been reported, there are few recent analyses. We performed a secondary analysis of data from the ABA2 trial (N = 185), in which detailed GVHD data were collected prospectively and systematically adjudicated. Analyses included cumulative incidence of classic versus ocGVHD, their specific organ manifestations, global disease severity scores, non-relapse mortality (NRM), disease-free survival (DFS) and overall survival (OS) in these two cGVHD subtypes. Of 92 patients who developed cGVHD, 35 were classified as ocGVHD. The 1-year cumulative incidence, organ involvement, and global severity of classic and ocGVHD were similar between ABA2 patients receiving CNI/MTX+placebo and CNI/MTX+abatacept; thus, cohorts were combined for ocGVHD evaluation. This analysis identified ocGVHD as having significantly higher severity at presentation and at maximum global severity compared to classic cGVHD. OS and DFS were significantly lower for ocGVHD versus classic cGVHD. OcGVHD is associated with increased cGVHD severity scores, and is associated with decreased OS and DFS compared to classic cGVHD, underscoring the high risks with this cGVHD subtype.
AB - Chronic graft-versus-host-disease (cGVHD) is divided into two subtypes: classic (absence of acute GVHD features) and overlap cGVHD (‘ocGVHD’), in which both chronic and acute GVHD clinical features are present simultaneously. While worse outcomes with ocGVHD have been reported, there are few recent analyses. We performed a secondary analysis of data from the ABA2 trial (N = 185), in which detailed GVHD data were collected prospectively and systematically adjudicated. Analyses included cumulative incidence of classic versus ocGVHD, their specific organ manifestations, global disease severity scores, non-relapse mortality (NRM), disease-free survival (DFS) and overall survival (OS) in these two cGVHD subtypes. Of 92 patients who developed cGVHD, 35 were classified as ocGVHD. The 1-year cumulative incidence, organ involvement, and global severity of classic and ocGVHD were similar between ABA2 patients receiving CNI/MTX+placebo and CNI/MTX+abatacept; thus, cohorts were combined for ocGVHD evaluation. This analysis identified ocGVHD as having significantly higher severity at presentation and at maximum global severity compared to classic cGVHD. OS and DFS were significantly lower for ocGVHD versus classic cGVHD. OcGVHD is associated with increased cGVHD severity scores, and is associated with decreased OS and DFS compared to classic cGVHD, underscoring the high risks with this cGVHD subtype.
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U2 - 10.1038/s41409-024-02245-y
DO - 10.1038/s41409-024-02245-y
M3 - Article
C2 - 38383714
AN - SCOPUS:85185483563
SN - 0268-3369
JO - Bone marrow transplantation
JF - Bone marrow transplantation
ER -