A NEW study found that chronic graft-versus-host disease (GVHD) is a key predictor for developing chronic GVHD after allogeneic hematopoietic cell transplantation (allo-HCT). Chronic GVHD is a significant complication that can occur after allo-HCT, a procedure often used to treat various blood cancer and disorders. The study used data from a Japanese registry and aimed to investigate whether the severity of acute GVHD directly impacts the risk and severity of chronic GVHD.
The study analysed data from 14,618 patients who underwent allo-HCT using bone marrow or peripheral blood (BM/PB) and 6,135 patients using umbilical cord blood (UCB). All patients had survived at least 100 days post-transplant without relapse. Researchers found that the risk of developing chronic GVHD requiring systemic steroids increased progressively with the severity of acute GVHD, up to grade 2. For patients with BM/PB transplants, those with acute GVHD grade 1 had a 32% higher risk of developing chronic GVHD compared to those with grade 0, while those with grade 2 had a 41% higher risk compared to grade 1.
Notably, the risk remained similar between acute GVHD grades 2 and 3-4 for developing chronic GVHD, although further analysis revealed that severe chronic GVHD risk continued to increase with each grade increment. For instance, patients with acute GVHD grade 3-4 had a 70% higher risk of severe chronic GVHD compared to those with grade 2. These trends were consistent across both BM/PB and UCB cohorts.
The findings suggest that acute GVHD serves as a critical marker for predicting the likelihood and severity of chronic GVHD. Understanding these risks could help healthcare providers develop more targeted strategies for managing chronic GVHD and ultimately improve the outcomes of patients who undergo allo-HCT.
Aleksandra Zurowska, EMJ
Reference
Tamaki et al. Associations between acute and chronic graft-versus-host disease. Blood Adv. 2024;8(16):4250-61.
