What is the outcome in patients with acute leukaemia who survive severe acute graft-versus-host disease?
J Intern Med
; 283(2): 166-177, 2018 02.
Article
em En
| MEDLINE
| ID: mdl-29027756
ABSTRACT
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.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Leucemia Mieloide Aguda
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Transplante de Células-Tronco Hematopoéticas
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Leucemia-Linfoma Linfoblástico de Células Precursoras
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Doença Enxerto-Hospedeiro
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Intern Med
Assunto da revista:
MEDICINA INTERNA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Suécia