Improved survival after acute graft-versus-host disease diagnosis in the modern era

Hanna J. Khoury, Tao Wang, Michael T. Hemmer, Daniel Couriel, Amin Alousi, Corey Cutler, Mahmoud Aljurf, Minoo Battiwalla, Jean Yves Cahn, Mitchell Cairo, Yi Bin Chen, Robert Peter Gale, Shahrukh Hashmi, Robert J. Hayashi, Madan Jagasia, Mark Juckett, Rammurti T. Kamble, Mohamed Kharfan-Dabaja, Mark R Litzow, Navneet MajhailAlan Miller, Taiga Nishihori, Muna Qayed, Joseph H. Antin, Helene Schoemans, Harry C. Schouten, Gerard Socie, Jan Storek, Leo Verdonck, Ravi Vij, William A. Wood, Lolie Yu, Rodrigo Martino, Matthew Carabasi, Christopher Dandoy, Usama Gergis, Peiman Hematti, Melham Solh, Kareem Jamani, Leslie Lehmann, Bipin Savani, Kirk R. Schultz, Baldeep M. Wirk, Stephen Spellman, Mukta Arora, Joseph Pidala

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Acute graft-versus-host disease remains a major threat to a successful outcome after allogeneic hematopoietic cell transplantation. While improvements in treatment and supportive care have occurred, it is unknown whether these advances have resulted in improved outcome specifically among those diagnosed with acute graft-versus-host disease. We examined outcome following diagnosis of grade II-IV acute graft-versus-host disease according to time period, and explored effects according to original graft-versus-host disease prophylaxis regimen and maximum overall grade of acute graft-versus-host disease. Between 1999 and 2012, 2,905 patients with acute myeloid leukemia (56%), acute lymphoblastic leukemia (30%) or myelodysplastic syndromes (14%) received a sibling (24%) or unrelated donor (76%) blood (66%) or marrow (34%) transplant and developed grade II-IV acute graft-versus-host disease (n=497 for 1999-2001, n=962 for 2002-2005, n=1,446 for 2006-2010). The median (range) follow-up was 144 (4-174), 97 (4-147) and 60 (8-99) months for 1999-2001, 2002-2005, and 2006-2010, respectively. Among the cohort with grade II-IV acute graft-versus-host disease, there was a decrease in the proportion of grade III-IV disease over time with 56%, 47%, and 37% for 1999-2001, 2002-2005, and 2006-2012, respectively (P<0.001). Considering the total study population, univariate analysis demonstrated significant improvements in overall survival and treatment-related mortality over time, and deaths from organ failure and infection declined. On multivariate analysis, significant improvements in overall survival (P=0.003) and treatment-related mortality (P=0.008) were only noted among those originally treated with tacrolimus-based graft-versus-host disease prophylaxis, and these effects were most apparent among those with overall grade II acute graft-versus-host disease. In conclusion, survival has improved over time for tacrolimus-treated transplant recipients with acute graft-versus-host disease.

Original languageEnglish (US)
Pages (from-to)958-966
Number of pages9
JournalHaematologica
Volume102
Issue number5
DOIs
StatePublished - Apr 30 2017

Fingerprint

Graft vs Host Disease
Survival
Tacrolimus
Unrelated Donors
Mortality
Myelodysplastic Syndromes
Cell Transplantation
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Acute Myeloid Leukemia
Siblings
Therapeutics
Multivariate Analysis
Bone Marrow
Transplants

ASJC Scopus subject areas

  • Hematology

Cite this

Khoury, H. J., Wang, T., Hemmer, M. T., Couriel, D., Alousi, A., Cutler, C., ... Pidala, J. (2017). Improved survival after acute graft-versus-host disease diagnosis in the modern era. Haematologica, 102(5), 958-966. https://doi.org/10.3324/haematol.2016.156356

Improved survival after acute graft-versus-host disease diagnosis in the modern era. / Khoury, Hanna J.; Wang, Tao; Hemmer, Michael T.; Couriel, Daniel; Alousi, Amin; Cutler, Corey; Aljurf, Mahmoud; Battiwalla, Minoo; Cahn, Jean Yves; Cairo, Mitchell; Chen, Yi Bin; Gale, Robert Peter; Hashmi, Shahrukh; Hayashi, Robert J.; Jagasia, Madan; Juckett, Mark; Kamble, Rammurti T.; Kharfan-Dabaja, Mohamed; Litzow, Mark R; Majhail, Navneet; Miller, Alan; Nishihori, Taiga; Qayed, Muna; Antin, Joseph H.; Schoemans, Helene; Schouten, Harry C.; Socie, Gerard; Storek, Jan; Verdonck, Leo; Vij, Ravi; Wood, William A.; Yu, Lolie; Martino, Rodrigo; Carabasi, Matthew; Dandoy, Christopher; Gergis, Usama; Hematti, Peiman; Solh, Melham; Jamani, Kareem; Lehmann, Leslie; Savani, Bipin; Schultz, Kirk R.; Wirk, Baldeep M.; Spellman, Stephen; Arora, Mukta; Pidala, Joseph.

In: Haematologica, Vol. 102, No. 5, 30.04.2017, p. 958-966.

Research output: Contribution to journalArticle

Khoury, HJ, Wang, T, Hemmer, MT, Couriel, D, Alousi, A, Cutler, C, Aljurf, M, Battiwalla, M, Cahn, JY, Cairo, M, Chen, YB, Gale, RP, Hashmi, S, Hayashi, RJ, Jagasia, M, Juckett, M, Kamble, RT, Kharfan-Dabaja, M, Litzow, MR, Majhail, N, Miller, A, Nishihori, T, Qayed, M, Antin, JH, Schoemans, H, Schouten, HC, Socie, G, Storek, J, Verdonck, L, Vij, R, Wood, WA, Yu, L, Martino, R, Carabasi, M, Dandoy, C, Gergis, U, Hematti, P, Solh, M, Jamani, K, Lehmann, L, Savani, B, Schultz, KR, Wirk, BM, Spellman, S, Arora, M & Pidala, J 2017, 'Improved survival after acute graft-versus-host disease diagnosis in the modern era', Haematologica, vol. 102, no. 5, pp. 958-966. https://doi.org/10.3324/haematol.2016.156356
Khoury HJ, Wang T, Hemmer MT, Couriel D, Alousi A, Cutler C et al. Improved survival after acute graft-versus-host disease diagnosis in the modern era. Haematologica. 2017 Apr 30;102(5):958-966. https://doi.org/10.3324/haematol.2016.156356
Khoury, Hanna J. ; Wang, Tao ; Hemmer, Michael T. ; Couriel, Daniel ; Alousi, Amin ; Cutler, Corey ; Aljurf, Mahmoud ; Battiwalla, Minoo ; Cahn, Jean Yves ; Cairo, Mitchell ; Chen, Yi Bin ; Gale, Robert Peter ; Hashmi, Shahrukh ; Hayashi, Robert J. ; Jagasia, Madan ; Juckett, Mark ; Kamble, Rammurti T. ; Kharfan-Dabaja, Mohamed ; Litzow, Mark R ; Majhail, Navneet ; Miller, Alan ; Nishihori, Taiga ; Qayed, Muna ; Antin, Joseph H. ; Schoemans, Helene ; Schouten, Harry C. ; Socie, Gerard ; Storek, Jan ; Verdonck, Leo ; Vij, Ravi ; Wood, William A. ; Yu, Lolie ; Martino, Rodrigo ; Carabasi, Matthew ; Dandoy, Christopher ; Gergis, Usama ; Hematti, Peiman ; Solh, Melham ; Jamani, Kareem ; Lehmann, Leslie ; Savani, Bipin ; Schultz, Kirk R. ; Wirk, Baldeep M. ; Spellman, Stephen ; Arora, Mukta ; Pidala, Joseph. / Improved survival after acute graft-versus-host disease diagnosis in the modern era. In: Haematologica. 2017 ; Vol. 102, No. 5. pp. 958-966.
@article{41cf399024bf49daa43ab0c45447d016,
title = "Improved survival after acute graft-versus-host disease diagnosis in the modern era",
abstract = "Acute graft-versus-host disease remains a major threat to a successful outcome after allogeneic hematopoietic cell transplantation. While improvements in treatment and supportive care have occurred, it is unknown whether these advances have resulted in improved outcome specifically among those diagnosed with acute graft-versus-host disease. We examined outcome following diagnosis of grade II-IV acute graft-versus-host disease according to time period, and explored effects according to original graft-versus-host disease prophylaxis regimen and maximum overall grade of acute graft-versus-host disease. Between 1999 and 2012, 2,905 patients with acute myeloid leukemia (56{\%}), acute lymphoblastic leukemia (30{\%}) or myelodysplastic syndromes (14{\%}) received a sibling (24{\%}) or unrelated donor (76{\%}) blood (66{\%}) or marrow (34{\%}) transplant and developed grade II-IV acute graft-versus-host disease (n=497 for 1999-2001, n=962 for 2002-2005, n=1,446 for 2006-2010). The median (range) follow-up was 144 (4-174), 97 (4-147) and 60 (8-99) months for 1999-2001, 2002-2005, and 2006-2010, respectively. Among the cohort with grade II-IV acute graft-versus-host disease, there was a decrease in the proportion of grade III-IV disease over time with 56{\%}, 47{\%}, and 37{\%} for 1999-2001, 2002-2005, and 2006-2012, respectively (P<0.001). Considering the total study population, univariate analysis demonstrated significant improvements in overall survival and treatment-related mortality over time, and deaths from organ failure and infection declined. On multivariate analysis, significant improvements in overall survival (P=0.003) and treatment-related mortality (P=0.008) were only noted among those originally treated with tacrolimus-based graft-versus-host disease prophylaxis, and these effects were most apparent among those with overall grade II acute graft-versus-host disease. In conclusion, survival has improved over time for tacrolimus-treated transplant recipients with acute graft-versus-host disease.",
author = "Khoury, {Hanna J.} and Tao Wang and Hemmer, {Michael T.} and Daniel Couriel and Amin Alousi and Corey Cutler and Mahmoud Aljurf and Minoo Battiwalla and Cahn, {Jean Yves} and Mitchell Cairo and Chen, {Yi Bin} and Gale, {Robert Peter} and Shahrukh Hashmi and Hayashi, {Robert J.} and Madan Jagasia and Mark Juckett and Kamble, {Rammurti T.} and Mohamed Kharfan-Dabaja and Litzow, {Mark R} and Navneet Majhail and Alan Miller and Taiga Nishihori and Muna Qayed and Antin, {Joseph H.} and Helene Schoemans and Schouten, {Harry C.} and Gerard Socie and Jan Storek and Leo Verdonck and Ravi Vij and Wood, {William A.} and Lolie Yu and Rodrigo Martino and Matthew Carabasi and Christopher Dandoy and Usama Gergis and Peiman Hematti and Melham Solh and Kareem Jamani and Leslie Lehmann and Bipin Savani and Schultz, {Kirk R.} and Wirk, {Baldeep M.} and Stephen Spellman and Mukta Arora and Joseph Pidala",
year = "2017",
month = "4",
day = "30",
doi = "10.3324/haematol.2016.156356",
language = "English (US)",
volume = "102",
pages = "958--966",
journal = "Haematologica",
issn = "0390-6078",
publisher = "Ferrata Storti Foundation",
number = "5",

}

TY - JOUR

T1 - Improved survival after acute graft-versus-host disease diagnosis in the modern era

AU - Khoury, Hanna J.

AU - Wang, Tao

AU - Hemmer, Michael T.

AU - Couriel, Daniel

AU - Alousi, Amin

AU - Cutler, Corey

AU - Aljurf, Mahmoud

AU - Battiwalla, Minoo

AU - Cahn, Jean Yves

AU - Cairo, Mitchell

AU - Chen, Yi Bin

AU - Gale, Robert Peter

AU - Hashmi, Shahrukh

AU - Hayashi, Robert J.

AU - Jagasia, Madan

AU - Juckett, Mark

AU - Kamble, Rammurti T.

AU - Kharfan-Dabaja, Mohamed

AU - Litzow, Mark R

AU - Majhail, Navneet

AU - Miller, Alan

AU - Nishihori, Taiga

AU - Qayed, Muna

AU - Antin, Joseph H.

AU - Schoemans, Helene

AU - Schouten, Harry C.

AU - Socie, Gerard

AU - Storek, Jan

AU - Verdonck, Leo

AU - Vij, Ravi

AU - Wood, William A.

AU - Yu, Lolie

AU - Martino, Rodrigo

AU - Carabasi, Matthew

AU - Dandoy, Christopher

AU - Gergis, Usama

AU - Hematti, Peiman

AU - Solh, Melham

AU - Jamani, Kareem

AU - Lehmann, Leslie

AU - Savani, Bipin

AU - Schultz, Kirk R.

AU - Wirk, Baldeep M.

AU - Spellman, Stephen

AU - Arora, Mukta

AU - Pidala, Joseph

PY - 2017/4/30

Y1 - 2017/4/30

N2 - Acute graft-versus-host disease remains a major threat to a successful outcome after allogeneic hematopoietic cell transplantation. While improvements in treatment and supportive care have occurred, it is unknown whether these advances have resulted in improved outcome specifically among those diagnosed with acute graft-versus-host disease. We examined outcome following diagnosis of grade II-IV acute graft-versus-host disease according to time period, and explored effects according to original graft-versus-host disease prophylaxis regimen and maximum overall grade of acute graft-versus-host disease. Between 1999 and 2012, 2,905 patients with acute myeloid leukemia (56%), acute lymphoblastic leukemia (30%) or myelodysplastic syndromes (14%) received a sibling (24%) or unrelated donor (76%) blood (66%) or marrow (34%) transplant and developed grade II-IV acute graft-versus-host disease (n=497 for 1999-2001, n=962 for 2002-2005, n=1,446 for 2006-2010). The median (range) follow-up was 144 (4-174), 97 (4-147) and 60 (8-99) months for 1999-2001, 2002-2005, and 2006-2010, respectively. Among the cohort with grade II-IV acute graft-versus-host disease, there was a decrease in the proportion of grade III-IV disease over time with 56%, 47%, and 37% for 1999-2001, 2002-2005, and 2006-2012, respectively (P<0.001). Considering the total study population, univariate analysis demonstrated significant improvements in overall survival and treatment-related mortality over time, and deaths from organ failure and infection declined. On multivariate analysis, significant improvements in overall survival (P=0.003) and treatment-related mortality (P=0.008) were only noted among those originally treated with tacrolimus-based graft-versus-host disease prophylaxis, and these effects were most apparent among those with overall grade II acute graft-versus-host disease. In conclusion, survival has improved over time for tacrolimus-treated transplant recipients with acute graft-versus-host disease.

AB - Acute graft-versus-host disease remains a major threat to a successful outcome after allogeneic hematopoietic cell transplantation. While improvements in treatment and supportive care have occurred, it is unknown whether these advances have resulted in improved outcome specifically among those diagnosed with acute graft-versus-host disease. We examined outcome following diagnosis of grade II-IV acute graft-versus-host disease according to time period, and explored effects according to original graft-versus-host disease prophylaxis regimen and maximum overall grade of acute graft-versus-host disease. Between 1999 and 2012, 2,905 patients with acute myeloid leukemia (56%), acute lymphoblastic leukemia (30%) or myelodysplastic syndromes (14%) received a sibling (24%) or unrelated donor (76%) blood (66%) or marrow (34%) transplant and developed grade II-IV acute graft-versus-host disease (n=497 for 1999-2001, n=962 for 2002-2005, n=1,446 for 2006-2010). The median (range) follow-up was 144 (4-174), 97 (4-147) and 60 (8-99) months for 1999-2001, 2002-2005, and 2006-2010, respectively. Among the cohort with grade II-IV acute graft-versus-host disease, there was a decrease in the proportion of grade III-IV disease over time with 56%, 47%, and 37% for 1999-2001, 2002-2005, and 2006-2012, respectively (P<0.001). Considering the total study population, univariate analysis demonstrated significant improvements in overall survival and treatment-related mortality over time, and deaths from organ failure and infection declined. On multivariate analysis, significant improvements in overall survival (P=0.003) and treatment-related mortality (P=0.008) were only noted among those originally treated with tacrolimus-based graft-versus-host disease prophylaxis, and these effects were most apparent among those with overall grade II acute graft-versus-host disease. In conclusion, survival has improved over time for tacrolimus-treated transplant recipients with acute graft-versus-host disease.

UR - http://www.scopus.com/inward/record.url?scp=85018996819&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018996819&partnerID=8YFLogxK

U2 - 10.3324/haematol.2016.156356

DO - 10.3324/haematol.2016.156356

M3 - Article

C2 - 28302712

AN - SCOPUS:85018996819

VL - 102

SP - 958

EP - 966

JO - Haematologica

JF - Haematologica

SN - 0390-6078

IS - 5

ER -