Steroid-Refractory Acute GVHD: Predictors and Outcomes
Patients with steroid-resistant acute graft versus host disease (aGVHD) have a dismal prognosis, with mortality rates in excess of 90%. We sought to identify a subgroup of patients less likely to benefit from initial therapy with corticosteroids as well as the impact of response on day 14 on outcom...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Advances in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2011/601953 |
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| author | Jason R. Westin Rima M. Saliba Marcos De Lima Amin Alousi Chitra Hosing Muzaffar H. Qazilbash Issa F. Khouri Elizabeth J. Shpall Paolo Anderlini Gabriela Rondon Borje S. Andersson Richard Champlin Daniel R. Couriel |
| author_facet | Jason R. Westin Rima M. Saliba Marcos De Lima Amin Alousi Chitra Hosing Muzaffar H. Qazilbash Issa F. Khouri Elizabeth J. Shpall Paolo Anderlini Gabriela Rondon Borje S. Andersson Richard Champlin Daniel R. Couriel |
| author_sort | Jason R. Westin |
| collection | DOAJ |
| description | Patients with steroid-resistant acute graft versus host disease (aGVHD) have a dismal prognosis, with mortality rates in excess of 90%. We sought to identify a subgroup of patients less likely to benefit from initial therapy with corticosteroids as well as the impact of response on day 14 on outcome. Retrospective evaluation was performed of patients with biopsy-proven aGVHD treated with corticosteroids after allogeneic HSCT at M.D. Anderson Cancer Center from 1998 through 2002 (𝑁=287). Overall response to first-line therapy on day 14 was 56%. Grade III-IV aGVHD and hyperacute GVHD were the most significant factors predicting failure. Patients who fail to respond to steroids by day 14 should be considered for clinical trials. Severity of aGVHD, hyperacute GVHD, and sex mismatch could be integrated into prognostic scoring systems which may allow for pretreatment identification of patients unlikely to benefit from standard therapy with corticosteroids. |
| format | Article |
| id | doaj-art-10fdb3c57b0c4114b28a6826d6ee477b |
| institution | Kabale University |
| issn | 1687-9104 1687-9112 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Hematology |
| spelling | doaj-art-10fdb3c57b0c4114b28a6826d6ee477b2025-02-03T06:05:37ZengWileyAdvances in Hematology1687-91041687-91122011-01-01201110.1155/2011/601953601953Steroid-Refractory Acute GVHD: Predictors and OutcomesJason R. Westin0Rima M. Saliba1Marcos De Lima2Amin Alousi3Chitra Hosing4Muzaffar H. Qazilbash5Issa F. Khouri6Elizabeth J. Shpall7Paolo Anderlini8Gabriela Rondon9Borje S. Andersson10Richard Champlin11Daniel R. Couriel12Stem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USAStem Cell Transplantation & Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX 77030, USABlood and Marrow Transplant Program, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI 48109, USAPatients with steroid-resistant acute graft versus host disease (aGVHD) have a dismal prognosis, with mortality rates in excess of 90%. We sought to identify a subgroup of patients less likely to benefit from initial therapy with corticosteroids as well as the impact of response on day 14 on outcome. Retrospective evaluation was performed of patients with biopsy-proven aGVHD treated with corticosteroids after allogeneic HSCT at M.D. Anderson Cancer Center from 1998 through 2002 (𝑁=287). Overall response to first-line therapy on day 14 was 56%. Grade III-IV aGVHD and hyperacute GVHD were the most significant factors predicting failure. Patients who fail to respond to steroids by day 14 should be considered for clinical trials. Severity of aGVHD, hyperacute GVHD, and sex mismatch could be integrated into prognostic scoring systems which may allow for pretreatment identification of patients unlikely to benefit from standard therapy with corticosteroids.http://dx.doi.org/10.1155/2011/601953 |
| spellingShingle | Jason R. Westin Rima M. Saliba Marcos De Lima Amin Alousi Chitra Hosing Muzaffar H. Qazilbash Issa F. Khouri Elizabeth J. Shpall Paolo Anderlini Gabriela Rondon Borje S. Andersson Richard Champlin Daniel R. Couriel Steroid-Refractory Acute GVHD: Predictors and Outcomes Advances in Hematology |
| title | Steroid-Refractory Acute GVHD: Predictors and Outcomes |
| title_full | Steroid-Refractory Acute GVHD: Predictors and Outcomes |
| title_fullStr | Steroid-Refractory Acute GVHD: Predictors and Outcomes |
| title_full_unstemmed | Steroid-Refractory Acute GVHD: Predictors and Outcomes |
| title_short | Steroid-Refractory Acute GVHD: Predictors and Outcomes |
| title_sort | steroid refractory acute gvhd predictors and outcomes |
| url | http://dx.doi.org/10.1155/2011/601953 |
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