Late acute graft versus host disease: a prospective analysis of clinical outcomes and circulating angiogenic factors
Standard
Late acute graft versus host disease: a prospective analysis of clinical outcomes and circulating angiogenic factors. / Holtan, Shernan G; Khera, Nandita; Levine, John E; Chai, Xiaoyu; Storer, Barry; Liu, Hien D; Inamoto, Yoshihiro; Chen, George L; Mayer, Sebastian; Arora, Mukta; Palmer, Jeanne; Flowers, Mary E D; Cutler, Corey S; Lukez, Alexander; Arai, Sally; Lazaryan, Aleksandr; Newell, Laura F; Krupski, Christa; Jagasia, Madan H; Pusic, Iskra; Wood, William; Renteria, Anne S; Yanik, Gregory; Hogan, William J; Hexner, Elizabeth; Ayuketang, Francis Ayuk; Holler, Ernst; Watanaboonyongcharoen, Phandee; Efebera, Yvonne A; Ferrara, James L M; Panoskaltsis-Mortari, Angela; Weisdorf, Daniel; Lee, Stephanie J; Pidala, Joseph.
In: BLOOD, Vol. 128, No. 19, 10.2016, p. 2350-2358.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Late acute graft versus host disease: a prospective analysis of clinical outcomes and circulating angiogenic factors
AU - Holtan, Shernan G
AU - Khera, Nandita
AU - Levine, John E
AU - Chai, Xiaoyu
AU - Storer, Barry
AU - Liu, Hien D
AU - Inamoto, Yoshihiro
AU - Chen, George L
AU - Mayer, Sebastian
AU - Arora, Mukta
AU - Palmer, Jeanne
AU - Flowers, Mary E D
AU - Cutler, Corey S
AU - Lukez, Alexander
AU - Arai, Sally
AU - Lazaryan, Aleksandr
AU - Newell, Laura F
AU - Krupski, Christa
AU - Jagasia, Madan H
AU - Pusic, Iskra
AU - Wood, William
AU - Renteria, Anne S
AU - Yanik, Gregory
AU - Hogan, William J
AU - Hexner, Elizabeth
AU - Ayuketang, Francis Ayuk
AU - Holler, Ernst
AU - Watanaboonyongcharoen, Phandee
AU - Efebera, Yvonne A
AU - Ferrara, James L M
AU - Panoskaltsis-Mortari, Angela
AU - Weisdorf, Daniel
AU - Lee, Stephanie J
AU - Pidala, Joseph
N1 - Copyright © 2016 American Society of Hematology.
PY - 2016/10
Y1 - 2016/10
N2 - Late acute (LA) graft vs. host disease (GVHD) is persistent, recurrent, or new onset acute GVHD symptoms occurring after 100 days post-allogeneic hematopoietic cell transplantation (HCT). The aim of this analysis is to describe the onset, course, morbidity, mortality, and examine angiogenic factors associated with LA GVHD. A prospective cohort of patients (n=909) was enrolled as part of an observational study within the Chronic GVHD Consortium. Eighty-three patients (11%) developed LA GVHD at a median of 160 (interquartile range, IQR 128-204) days after HCT. While 51/83 (61%) achieved complete or partial response to initial therapy by 28 days, median failure free survival was only 7.1 months (95% confidence interval 3.4-19.1 months), and estimated overall survival (OS) at two years was 56%. Given recently described alterations of circulating angiogenic factors in classic acute GVHD, we examined whether alterations in such factors could be identified in LA GVHD. We first tested cases (n-55) and controls (n=50) from the Chronic GVHD Consortium and then validated the findings in 37 cases from Mount Sinai Acute GVHD International Consortium. Plasma amphiregulin (AREG, an epidermal growth factor [EGF] receptor ligand) was elevated, and the AREG/EGF ratio ≥ median was associated with inferior OS and increased NRM in both cohorts. Elevation of AREG was detected in classic acute GVHD, but not chronic GVHD. These prospective data characterize the clinical course of LA GVHD, and demonstrate alterations in angiogenic factors that make LA GVHD biologically distinct from chronic GVHD.
AB - Late acute (LA) graft vs. host disease (GVHD) is persistent, recurrent, or new onset acute GVHD symptoms occurring after 100 days post-allogeneic hematopoietic cell transplantation (HCT). The aim of this analysis is to describe the onset, course, morbidity, mortality, and examine angiogenic factors associated with LA GVHD. A prospective cohort of patients (n=909) was enrolled as part of an observational study within the Chronic GVHD Consortium. Eighty-three patients (11%) developed LA GVHD at a median of 160 (interquartile range, IQR 128-204) days after HCT. While 51/83 (61%) achieved complete or partial response to initial therapy by 28 days, median failure free survival was only 7.1 months (95% confidence interval 3.4-19.1 months), and estimated overall survival (OS) at two years was 56%. Given recently described alterations of circulating angiogenic factors in classic acute GVHD, we examined whether alterations in such factors could be identified in LA GVHD. We first tested cases (n-55) and controls (n=50) from the Chronic GVHD Consortium and then validated the findings in 37 cases from Mount Sinai Acute GVHD International Consortium. Plasma amphiregulin (AREG, an epidermal growth factor [EGF] receptor ligand) was elevated, and the AREG/EGF ratio ≥ median was associated with inferior OS and increased NRM in both cohorts. Elevation of AREG was detected in classic acute GVHD, but not chronic GVHD. These prospective data characterize the clinical course of LA GVHD, and demonstrate alterations in angiogenic factors that make LA GVHD biologically distinct from chronic GVHD.
KW - Journal Article
U2 - 10.1182/blood-2015-09-669846
DO - 10.1182/blood-2015-09-669846
M3 - SCORING: Journal article
C2 - 27625357
VL - 128
SP - 2350
EP - 2358
JO - BLOOD
JF - BLOOD
SN - 0006-4971
IS - 19
ER -
