Serositis Associated with Chronic Graft-Versus-Host Disease
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Published on: May 7, 2019
Te Bs Chloe1, Elahi Bs Taara1, Samples Kenna1
1Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington.
Insights
Serositis, a complication of chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation (HCT), can significantly impact patients. This study highlights its occurrence, management, and survival outcomes, emphasizing the need for further research.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Serositis is a known complication of chronic graft-versus-host disease (cGVHD).
- It occurs in patients following allogeneic hematopoietic cell transplantation (HCT).
- Limited data exist on cGVHD-associated serositis, including patient demographics, incidence, risk factors, and management.
Purpose of the Study:
- To describe the patient population, incidence, risk factors, and management strategies for cGVHD-associated serositis.
- To analyze clinical outcomes and survival associated with serositis post-HCT.
Main Methods:
- Retrospective analysis of 50 adult patients who underwent HCT and developed cGVHD-associated serositis.
- Data collected from Fred Hutchinson Cancer Center between 1998 and 2021.
- Review of patient demographics, serositis types (pleural and pericardial effusions), management, recurrence, and survival.
Main Results:
- Most common manifestations were pericardial effusions (n=31) and pleural effusions (n=38).
- Medical management was utilized in 94% for pleural and 87% for pericardial effusions.
- Eleven patients experienced recurrent serositis.
- Median overall survival at 1-year post-diagnosis was 86%, and 69% at 3-years.
Conclusions:
- Serositis is a serious, atypical manifestation of cGVHD.
- Further prospective studies with larger cohorts are needed to optimize treatment strategies and improve outcomes.
Abstract:
Serositis is a recognized complication associated with chronic graft-versus-host disease (cGVHD) in patients who undergo allogeneic hematopoietic cell transplantation (HCT). Although it is uncommon, serositis after HCT can have significant negative clinical impacts. There are limited data describing the patient population, incidence, risk factors, and management strategies of cGVHD-associated serositis. We retrospectively identified 50 adult patients who underwent HCT at the Fred Hutchinson Cancer Center between 1998 and 2021 and developed serositis attributed to cGVHD. Most patients developed pericardial effusions (n = 31) and/or pleural effusions (n = 38). Overall, 94% of patients with pleural effusion and 87% of patients with pericardial effusion received medical management for their serositis. Eleven patients experienced at least one recurrence of serositis. The median overall survival for all serositis types at 1-year postserositis diagnosis was 86%, and 69% for 3-year postserositis diagnosis. Serositis is a serious atypical cGVHD manifestation, and prospective data collected from a larger cohort of patients is required to better understand favorable treatment strategies and outcomes of this complication.
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