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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.
Afiliación
  • Ringdén O; Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
  • Labopin M; Hôpital Saint Antoine, Paris, France.
  • Sadeghi B; Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
  • Mailhol A; Hôpital Saint Antoine, Paris, France.
  • Beelen D; University of Essen, Duisburg, Germany.
  • Fløisand Y; Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
  • Ghavamzadeh A; Shariati Hospital, Hematology-Oncology and BMT Research, Tehran, Iran.
  • Finke J; Department of Medicine-Hematology, Oncology, University of Freiburg, Freiburg, Germany.
  • Ehninger G; Medizinische Klinik und Poliklinik 1, Universitätsklinikum Dresden, Dresden, Germany.
  • Volin L; Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki University Hospital, Helsinki, Finland.
  • Socié G; Department of Hematology - BMT, Hopital St. Louis, Paris, France.
  • Kröger N; Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany.
  • Stuhler G; Deutsche Klinik für Diagnostik, KMT Zentrum, Wiesbaden, Germany.
  • Ganser A; Medical University Hannover, Hannover, Germany.
  • Schmid C; University of Munich, Munich, Germany.
  • Giebel S; Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.
  • Mohty M; Hôpital Saint Antoine, Paris, France.
  • Nagler A; Chaim Sheba Medical Center, Tel-Hashomer, Israel.
J Intern Med ; 283(2): 166-177, 2018 02.
Article en En | MEDLINE | ID: mdl-29027756
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Mieloide Aguda / Trasplante de Células Madre Hematopoyéticas / Leucemia-Linfoma Linfoblástico de Células Precursoras / Enfermedad Injerto contra Huésped Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2018 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Mieloide Aguda / Trasplante de Células Madre Hematopoyéticas / Leucemia-Linfoma Linfoblástico de Células Precursoras / Enfermedad Injerto contra Huésped Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2018 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido