A Prospective, Longitudinal Observation of the Incidence, Treatment, and Survival of Late Acute and Chronic Graft-versus-Host Disease by National Institutes of Health Criteria in a Japanese Cohort

Chikako Ohwada, Emiko Sakaida, Aiko Igarashi, Takeshi Kobayashi, Noriko Doki, Takehiko Mori, Jun Kato, Yuya Koda, Heiwa Kanamori, Masatsugu Tanaka, Takayoshi Tachibana, Shin Fujisawa, Yuki Nakajima, Ayumi Numata, Masako Toyosaki, Yasuyuki Aoyama, Makoto Onizuka, Maki Hagihara, Satoshi Koyama, Yoshinobu KandaHideki Nakasone, Hiroaki Shimizu, Seiko Kato, Reiko Watanabe, Katsuhiro Shono, Rika Sakai, Takeshi Saito, Chiaki Nakaseko, Shinichiro Okamoto

研究成果: Article

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To prospectively validate the incidence, manifestations, and outcomes of graft-versus-host disease (GVHD) by National Institutes of Health criteria, we recruited 406 hematopoietic stem cell transplantation recipients at 16 transplant centers in Japan from May 2012 to June 2014. The 2-year cumulative incidence of late acute and chronic GVHD was 3.2% (n = 13) and 35.4% (n = 145), with a median onset of 3.6 and 4.7 months after transplant, respectively. The global severity at onset was mild in 30.3%, moderate in 43.5%, and severe in 26.2%. Eighty-two patients were followed up for 2 years, with 79.3% still manifesting GVHD symptoms, and 80.6% (n = 117) of the patients received systemic immunosuppressive treatment (IST), with a 2-year cumulative incidence of IST termination of 33.1%. Severe patients showed a significantly lower rate of IST termination than those with mild and moderate severities (mild, 38.5%; moderate, 40.9%; and severe, 17.2%). The 2-year incidence of nonrelapse mortality (NRM) and relapse was not significantly different according to the severity at onset (NRM: mild [16.6%] versus moderate [8.7%] versus severe [16.1%]; relapse: mild [14.9%] versus moderate [14.7%] versus severe [5.3%]). As a result, 2-year overall survival (OS) and GVHD-specific survival (GSS) were equivalent according to the severity at onset (mild: OS = 81.0%, GSS = 85.7%; moderate: OS = 84.2%, GSS = 92.5%; severe: OS = 83.9%, GSS = 89.2%). Our study helped identify the characteristics of late acute and chronic GVHD in Japanese patients. Further investigation is needed to identify an optimal endpoint for survival prediction.

元の言語English
ページ(範囲)162-170
ページ数9
ジャーナルBiology of Blood and Marrow Transplantation
26
発行部数1
DOI
出版物ステータスPublished - 2020 1

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Ohwada, C., Sakaida, E., Igarashi, A., Kobayashi, T., Doki, N., Mori, T., Kato, J., Koda, Y., Kanamori, H., Tanaka, M., Tachibana, T., Fujisawa, S., Nakajima, Y., Numata, A., Toyosaki, M., Aoyama, Y., Onizuka, M., Hagihara, M., Koyama, S., ... Okamoto, S. (2020). A Prospective, Longitudinal Observation of the Incidence, Treatment, and Survival of Late Acute and Chronic Graft-versus-Host Disease by National Institutes of Health Criteria in a Japanese Cohort. Biology of Blood and Marrow Transplantation, 26(1), 162-170. https://doi.org/10.1016/j.bbmt.2019.09.016