What is the outcome in patients with acute leukaemia who survive severe acute graft-versus-host disease?
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What is the outcome in patients with acute leukaemia who survive severe acute graft-versus-host disease? / 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.
In: J INTERN MED, Vol. 283, No. 2, 02.2018, p. 166-177.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - What is the outcome in patients with acute leukaemia who survive severe acute graft-versus-host disease?
AU - Ringdén, O
AU - Labopin, M
AU - Sadeghi, B
AU - Mailhol, A
AU - Beelen, D
AU - Fløisand, Y
AU - Ghavamzadeh, A
AU - Finke, J
AU - Ehninger, G
AU - Volin, L
AU - Socié, G
AU - Kröger, N
AU - Stuhler, G
AU - Ganser, A
AU - Schmid, C
AU - Giebel, S
AU - Mohty, M
AU - Nagler, A
N1 - © 2017 The Association for the Publication of the Journal of Internal Medicine.
PY - 2018/2
Y1 - 2018/2
N2 - 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.
AB - 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.
KW - Journal Article
U2 - 10.1111/joim.12695
DO - 10.1111/joim.12695
M3 - SCORING: Journal article
C2 - 29027756
VL - 283
SP - 166
EP - 177
JO - J INTERN MED
JF - J INTERN MED
SN - 0954-6820
IS - 2
ER -