What is the outcome in patients with acute leukaemia who survive severe acute graft‐versus‐host disease?. (3rd November 2017)

• Record Type: Journal Article
• Authors: Ringdén, O.; Labopin, M.; Sadeghi, B.; Mailhol, A.; Beelen, D.; Fløisand, Y.; Ghavamzadeh, A.; Finke, J.; Ehninger, G.; Volin, L.; Socié, G.; Kröger, N.; Stuhler, G.; Ganser, A.; Schmid, C.; Giebel, S.; Mohty, M.; Nagler, A.
• Is Part Of: Journal of internal medicine. Volume 283:Number 2(2018)
• Page Start: 166
• Page End: 177
• Publication Date: 2017-11-03
• Subjects: acute graft‐versus‐host disease -- acute myeloid leukaemia -- acute lymphoblastic leukaemia -- allogeneic haematopoietic stem cell transplantation; Internal medicine -- Periodicals; Medicine -- Periodicals; 616
• DOI: 10.1111/joim.12695
• Languages: English
• ISSNs: 0954-6820

Abstract

Abstract: Background: Acute graft‐versus‐host disease (aGVHD) is a major complication of allogeneic haematopoietic stem cell transplantation (HSCT). With new promising therapies, survival may improve for severe aGVHD. Objectives: We wanted to analyze the long‐term outcome in patients who survive severe aGVHD. Methods: This study was a landmark analysis of 23 567 patients with acute Leukaemia who survived for more than 6 months after HSCT, 2002–2014. Patients alive after severe aGVHD ( n = 1738) were compared to controls. Results: Patients with severe aGVHD had higher non‐relapse mortality (NRM) and higher rate of extensive chronic GVHD (cGVHD) than the controls ( P < 10 −5 ). The probability of relapse was significantly lower in the severe aGVHD group, but Leukaemia‐free survival (LFS) and overall survival were significantly lower than for the controls ( P < 10 −5 ). Five‐year LFS in patients with severe aGVHD was 49%, as opposed to 61% in controls with no or mild GVHD and 59% in patients with moderate GVHD. Conclusions: HSCT patients who survive severe aGVHD have higher risk of developing extensive cGVHD, a higher NRM, a lower relapse probability, and lower LFS than other HSCT patients. This study is a platform for outcome analysis in patients treated with novel therapies for acute GVHD.