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Retrospective single center analysis of outcome, risk factors and therapy in steroid refractory graft-versus-host disease after allogeneic hematopoietic cell transplantation

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Retrospective single center analysis of outcome, risk factors and therapy in steroid refractory graft-versus-host disease after allogeneic hematopoietic cell transplantation. / Axt, L; Naumann, A; Toennies, J; Haen, S P; Vogel, W; Schneidawind, D; Wirths, S; Moehle, R; Faul, C; Kanz, L; Axt, S; Bethge, W A.

In: BONE MARROW TRANSPL, Vol. 54, No. 11, 11.2019, p. 1805-1814.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Axt, L, Naumann, A, Toennies, J, Haen, SP, Vogel, W, Schneidawind, D, Wirths, S, Moehle, R, Faul, C, Kanz, L, Axt, S & Bethge, WA 2019, 'Retrospective single center analysis of outcome, risk factors and therapy in steroid refractory graft-versus-host disease after allogeneic hematopoietic cell transplantation', BONE MARROW TRANSPL, vol. 54, no. 11, pp. 1805-1814. https://doi.org/10.1038/s41409-019-0544-y

APA

Axt, L., Naumann, A., Toennies, J., Haen, S. P., Vogel, W., Schneidawind, D., Wirths, S., Moehle, R., Faul, C., Kanz, L., Axt, S., & Bethge, W. A. (2019). Retrospective single center analysis of outcome, risk factors and therapy in steroid refractory graft-versus-host disease after allogeneic hematopoietic cell transplantation. BONE MARROW TRANSPL, 54(11), 1805-1814. https://doi.org/10.1038/s41409-019-0544-y

Vancouver

Axt L, Naumann A, Toennies J, Haen SP, Vogel W, Schneidawind D et al. Retrospective single center analysis of outcome, risk factors and therapy in steroid refractory graft-versus-host disease after allogeneic hematopoietic cell transplantation. BONE MARROW TRANSPL. 2019 Nov;54(11):1805-1814. https://doi.org/10.1038/s41409-019-0544-y

Bibtex

@article{4a49f3de6312469cac9999b0f7e93ce5,
title = "Retrospective single center analysis of outcome, risk factors and therapy in steroid refractory graft-versus-host disease after allogeneic hematopoietic cell transplantation",
abstract = "Acute and chronic graft-vs.-host disease (aGvHD and cGvHD) are major complications after allogeneic hematopoietic cell transplantation (HCT) leading to substantial morbidity and mortality. This retrospective single-center study analyzes incidence, therapy, and outcome of GvHD in n = 721 patients ≥18 years having received allogeneic HCT 2004-2013 with a special focus on steroid refractory GvHD. Acute (n = 355/49.2%) and chronic (n = 269/37.3%) GvHD were mainly treated by steroids in first-line therapy. The proportion of steroid refractory aGvHD and cGvHD was 35.7% and 31.4%, respectively. As there is no standard therapy for steroid refractory GvHD, a range of different agents was used. In aGvHD, the overall response rate (ORR) of steroid refractory GvHD to second-line treatment was 27.4%. Mycophenolate mofetil (MMF) and mTOR inhibitors led to superior response rates (ORR 50.0% and 53.3%, respectively). In steroid refractory cGvHD therapy, ORR was 44.4%. Use of calcineurin inhibitors (CNI; n = 11/45.5%), MMF (n = 18/50.0%), mTOR inhibitors (n = 10/60.0%), and extracorporeal photophoresis (ECP; n = 16/56.3%) showed ORR above average. Targeted therapies lead to responses in 7.7% (n = 13). This data may help to improve the design of future prospective clinical studies in GvHD.",
author = "L Axt and A Naumann and J Toennies and Haen, {S P} and W Vogel and D Schneidawind and S Wirths and R Moehle and C Faul and L Kanz and S Axt and Bethge, {W A}",
year = "2019",
month = nov,
doi = "10.1038/s41409-019-0544-y",
language = "English",
volume = "54",
pages = "1805--1814",
journal = "BONE MARROW TRANSPL",
issn = "0268-3369",
publisher = "NATURE PUBLISHING GROUP",
number = "11",

}

RIS

TY - JOUR

T1 - Retrospective single center analysis of outcome, risk factors and therapy in steroid refractory graft-versus-host disease after allogeneic hematopoietic cell transplantation

AU - Axt, L

AU - Naumann, A

AU - Toennies, J

AU - Haen, S P

AU - Vogel, W

AU - Schneidawind, D

AU - Wirths, S

AU - Moehle, R

AU - Faul, C

AU - Kanz, L

AU - Axt, S

AU - Bethge, W A

PY - 2019/11

Y1 - 2019/11

N2 - Acute and chronic graft-vs.-host disease (aGvHD and cGvHD) are major complications after allogeneic hematopoietic cell transplantation (HCT) leading to substantial morbidity and mortality. This retrospective single-center study analyzes incidence, therapy, and outcome of GvHD in n = 721 patients ≥18 years having received allogeneic HCT 2004-2013 with a special focus on steroid refractory GvHD. Acute (n = 355/49.2%) and chronic (n = 269/37.3%) GvHD were mainly treated by steroids in first-line therapy. The proportion of steroid refractory aGvHD and cGvHD was 35.7% and 31.4%, respectively. As there is no standard therapy for steroid refractory GvHD, a range of different agents was used. In aGvHD, the overall response rate (ORR) of steroid refractory GvHD to second-line treatment was 27.4%. Mycophenolate mofetil (MMF) and mTOR inhibitors led to superior response rates (ORR 50.0% and 53.3%, respectively). In steroid refractory cGvHD therapy, ORR was 44.4%. Use of calcineurin inhibitors (CNI; n = 11/45.5%), MMF (n = 18/50.0%), mTOR inhibitors (n = 10/60.0%), and extracorporeal photophoresis (ECP; n = 16/56.3%) showed ORR above average. Targeted therapies lead to responses in 7.7% (n = 13). This data may help to improve the design of future prospective clinical studies in GvHD.

AB - Acute and chronic graft-vs.-host disease (aGvHD and cGvHD) are major complications after allogeneic hematopoietic cell transplantation (HCT) leading to substantial morbidity and mortality. This retrospective single-center study analyzes incidence, therapy, and outcome of GvHD in n = 721 patients ≥18 years having received allogeneic HCT 2004-2013 with a special focus on steroid refractory GvHD. Acute (n = 355/49.2%) and chronic (n = 269/37.3%) GvHD were mainly treated by steroids in first-line therapy. The proportion of steroid refractory aGvHD and cGvHD was 35.7% and 31.4%, respectively. As there is no standard therapy for steroid refractory GvHD, a range of different agents was used. In aGvHD, the overall response rate (ORR) of steroid refractory GvHD to second-line treatment was 27.4%. Mycophenolate mofetil (MMF) and mTOR inhibitors led to superior response rates (ORR 50.0% and 53.3%, respectively). In steroid refractory cGvHD therapy, ORR was 44.4%. Use of calcineurin inhibitors (CNI; n = 11/45.5%), MMF (n = 18/50.0%), mTOR inhibitors (n = 10/60.0%), and extracorporeal photophoresis (ECP; n = 16/56.3%) showed ORR above average. Targeted therapies lead to responses in 7.7% (n = 13). This data may help to improve the design of future prospective clinical studies in GvHD.

U2 - 10.1038/s41409-019-0544-y

DO - 10.1038/s41409-019-0544-y

M3 - SCORING: Journal article

C2 - 31089279

VL - 54

SP - 1805

EP - 1814

JO - BONE MARROW TRANSPL

JF - BONE MARROW TRANSPL

SN - 0268-3369

IS - 11

ER -