Association of Country-Specific Socioeconomic Factors With Survival of Patients Who Experience Severe Classic Acute Graft-vs.-Host Disease After Allogeneic Hematopoietic Cell Transplantation. An Analysis From the Transplant Complications Working Party of the EBMT
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Association of Country-Specific Socioeconomic Factors With Survival of Patients Who Experience Severe Classic Acute Graft-vs.-Host Disease After Allogeneic Hematopoietic Cell Transplantation. An Analysis From the Transplant Complications Working Party of the EBMT. / Frankiewicz, Andrzej; Peczynski, Christophe; Giebel, Sebastian; Harrington, Alenca; Socié, Gerard; Niederwieser, Dietger; Scheid, Christoph; Bornhäuser, Martin; Kröger, Nicolaus; Elmaagacli, Ahmet; Afanasyev, Boris; Dreger, Peter; Rössig, Claudia; Blaise, Didier; Kratz, Christian; Yakoub-Agha, Ibrahim; Kremens, Bernhard; Niemeyer, Charlotte Marie; Wulf, Gerald; Blau, Igor; Penack, Olaf; Greinix, Hildegard; Basak, Grzegorz W.
In: FRONT IMMUNOL, Vol. 11, 2020, p. 1537.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Association of Country-Specific Socioeconomic Factors With Survival of Patients Who Experience Severe Classic Acute Graft-vs.-Host Disease After Allogeneic Hematopoietic Cell Transplantation. An Analysis From the Transplant Complications Working Party of the EBMT
AU - Frankiewicz, Andrzej
AU - Peczynski, Christophe
AU - Giebel, Sebastian
AU - Harrington, Alenca
AU - Socié, Gerard
AU - Niederwieser, Dietger
AU - Scheid, Christoph
AU - Bornhäuser, Martin
AU - Kröger, Nicolaus
AU - Elmaagacli, Ahmet
AU - Afanasyev, Boris
AU - Dreger, Peter
AU - Rössig, Claudia
AU - Blaise, Didier
AU - Kratz, Christian
AU - Yakoub-Agha, Ibrahim
AU - Kremens, Bernhard
AU - Niemeyer, Charlotte Marie
AU - Wulf, Gerald
AU - Blau, Igor
AU - Penack, Olaf
AU - Greinix, Hildegard
AU - Basak, Grzegorz W
N1 - Copyright © 2020 Frankiewicz, Peczynski, Giebel, Harrington, Socié, Niederwieser, Scheid, Bornhäuser, Kröger, Elmaagacli, Afanasyev, Dreger, Rössig, Blaise, Kratz, Yakoub-Agha, Kremens, Niemeyer, Wulf, Blau, Penack, Greinix and Basak.
PY - 2020
Y1 - 2020
N2 - Acute graft-vs.-host disease (aGvHD) is one of the most frequent causes of transplant-related mortality (TRM) after allogeneic hematopoietic cell transplantation (alloHCT). Its treatment is complex and costly. The aim of this study was to retrospectively analyze the impact of country-specific socioeconomic factors on outcome of patients who experience severe aGvHD. Adults with hematological malignancies receiving alloHCT from either HLA-matched siblings (n = 1,328) or unrelated donors (n = 2,824) developing grade 3 or 4 aGvHD were included. In univariate analysis, the probability of TRM at 2 years was increased for countries with lower current Health Care Expenditure (HCE, p = 0.04), lower HCE as % of Gross Domestic Product per capita (p = 0.003) and lower values of the Human Development Index (p = 0.02). In a multivariate model, the risk of TRM was most strongly predicted by current HCE (HR = 0.76, p = 0.006). HCE >median was also associated with reduced risk of the overall mortality (HR 0.73, p = 0.0006) and reduced risk of treatment failure (either relapse or TRM; HR 0.77, p = 0.004). We conclude that country-specific socioeconomic factors, in particular current HCE, are strongly associated with survival of patients who experience severe aGvHD.
AB - Acute graft-vs.-host disease (aGvHD) is one of the most frequent causes of transplant-related mortality (TRM) after allogeneic hematopoietic cell transplantation (alloHCT). Its treatment is complex and costly. The aim of this study was to retrospectively analyze the impact of country-specific socioeconomic factors on outcome of patients who experience severe aGvHD. Adults with hematological malignancies receiving alloHCT from either HLA-matched siblings (n = 1,328) or unrelated donors (n = 2,824) developing grade 3 or 4 aGvHD were included. In univariate analysis, the probability of TRM at 2 years was increased for countries with lower current Health Care Expenditure (HCE, p = 0.04), lower HCE as % of Gross Domestic Product per capita (p = 0.003) and lower values of the Human Development Index (p = 0.02). In a multivariate model, the risk of TRM was most strongly predicted by current HCE (HR = 0.76, p = 0.006). HCE >median was also associated with reduced risk of the overall mortality (HR 0.73, p = 0.0006) and reduced risk of treatment failure (either relapse or TRM; HR 0.77, p = 0.004). We conclude that country-specific socioeconomic factors, in particular current HCE, are strongly associated with survival of patients who experience severe aGvHD.
U2 - 10.3389/fimmu.2020.01537
DO - 10.3389/fimmu.2020.01537
M3 - SCORING: Journal article
C2 - 32793210
VL - 11
SP - 1537
JO - FRONT IMMUNOL
JF - FRONT IMMUNOL
SN - 1664-3224
ER -