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Updated: Jun 24, 2025
Bone Marrow Transplantation Platform to Investigate the Role of Dendritic Cells in Graft-versus-Host Disease
Published on: March 17, 2020
Impact of chronic graft-versus-host disease on non-relapse mortality and survival
Justin Jiang1, Audrey M Sigmund2, Qiuhong Zhao2
1The Ohio State University College of Medicine, Columbus, OH, USA.
Insights
Chronic graft-versus-host-disease (cGVHD) significantly increases non-relapse mortality after allogeneic hematopoietic stem cell transplantation (allo-HCT). This risk is consistent across older and younger patient groups, highlighting cGVHD
Area of Science:
- Hematology
- Transplantation Immunology
- Oncology
Background:
- Allogeneic hematopoietic stem cell transplantation (allo-HCT) is a life-saving procedure for various hematologic malignancies and other conditions.
- Chronic graft-versus-host-disease (cGVHD) remains a major cause of morbidity and mortality post-allo-HCT.
- Increasing numbers of older adults are undergoing allo-HCT, necessitating an understanding of age-related outcomes.
Purpose of the Study:
- To evaluate the impact of cGVHD on patient outcomes following allo-HCT.
- To compare the effects of cGVHD on outcomes between older (≥60 years) and younger (<60 years) adult patients.
Main Methods:
- Retrospective analysis of patients undergoing allo-HCT between 1999 and 2018.
- Assessment of cGVHD development by Day +180 post-transplant.
- Comparison of outcomes, including non-relapse mortality (NRM), between patients with and without cGVHD, stratified by age.
Main Results:
- Patients who developed cGVHD by Day +180 had a significantly increased risk and incidence of NRM compared to those without cGVHD.
- No significant difference in outcomes was observed between older and younger patients who developed cGVHD.
- cGVHD is associated with substantial morbidity irrespective of patient age.
Conclusions:
- cGVHD is a critical determinant of adverse outcomes, particularly NRM, after allo-HCT.
- The detrimental impact of cGVHD on allo-HCT outcomes is not significantly influenced by patient age (≥60 vs <60 years).
- Strategies to mitigate cGVHD are crucial for improving survival in allogeneic transplant recipients.
Abstract:
Chronic graft-versus-host-disease (cGVHD) is one of the primary causes of morbidity and mortality for patients who undergo allogeneic hematopoietic stem cell transplantation (allo-HCT). In recent years, advancements in allo-HCT have allowed a broader range of patients to receive transplant, particularly older patients. We sought to assess the impact of cGVHD on outcomes in patients undergoing allo-HCT, for older patients as compared to their counterparts. We performed a retrospective analysis of all patients who underwent allo-HCT 1999-2018. Our results showed that those patients who developed cGVHD by D + 180 had an increased risk and incidence of NRM as compared to those patients without cGVHD. There was no significant difference in outcomes for those patients with cGVHD by age (≥60 years old [yo] and <60 yo). These findings suggest the significant morbidity of cGVHD, regardless of age.
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