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Updated: Aug 3, 2025

High Throughput Sequential ELISA for Validation of Biomarkers of Acute Graft-Versus-Host Disease
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High Throughput Sequential ELISA for Validation of Biomarkers of Acute Graft-Versus-Host Disease

Published on: October 31, 2012

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Chronic GVHD after steroid-sensitive, -dependent, and -refractory acute GVHD: incidence and clinical outcomes

Shannon Herzog1,2, Daniel J Weisdorf1,2, Ryan Shanley3

  • 1Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN.

Blood Advances
|April 10, 2023
PubMed

Insights

Previous acute graft-versus-host disease (aGVHD) response impacts chronic GVHD (cGVHD) risk and severity. Steroid-dependent (SD) and steroid-resistant (SR) aGVHD are risk factors for cGVHD, with similar poor prognoses. Steroid-sensitive (SS) aGVHD is not a risk factor.

Area of Science:

  • Hematology
  • Immunology
  • Oncology

Background:

  • Chronic graft-versus-host disease (cGVHD) is a significant complication following allogeneic hematopoietic cell transplantation (HCT).
  • Acute GVHD (aGVHD) response to first-line corticosteroids defines steroid-sensitive (SS), steroid-dependent (SD), and steroid-resistant (SR) groups.
  • Understanding the relationship between prior aGVHD response and subsequent cGVHD is crucial for improving patient outcomes.

Purpose of the Study:

  • To assess the incidence, risk factors, and clinical outcomes of cGVHD in patients with a history of SS, SD, or SR aGVHD.
  • To compare these outcomes with patients who did not develop aGVHD.
  • To determine if prior aGVHD response status predicts cGVHD severity and prognosis.

Main Methods:

  • Retrospective, single-institution cohort study of 784 adult and pediatric HCT recipients for hematologic malignancies (2008-2016).
  • Analysis of aGVHD incidence and response categories (SS, SD, SR).
  • Evaluation of 3-year cumulative incidence of cGVHD and its association with prior aGVHD status and severity.

Main Results:

  • The 3-year cumulative incidence of cGVHD was 25%.
  • SD and SR aGVHD were identified as independent risk factors for developing cGVHD; SS aGVHD was not.
  • cGVHD following SD and SR aGVHD had similar, poorer prognoses, contrary to the hypothesis of an intermediate prognosis for SD aGVHD.

Conclusions:

  • Previous aGVHD response status, particularly SD and SR, are significant predictors of cGVHD development and severity.
  • Patients with prior SD or SR aGVHD face similar adverse outcomes for subsequent cGVHD.
  • These findings highlight the importance of considering aGVHD response in predicting and managing cGVHD post-HCT.

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