Chronic Graft-versus-Host disease trends over 30 years - a study by the EBMT transplant complications working party

Area of Science:

• Hematology
• Immunology
• Oncology

Background:

• Allogeneic hematopoietic stem cell transplantation (alloHSCT) is a curative therapy for hematological malignancies.
• Chronic Graft-versus-Host Disease (cGvHD) is a significant complication impacting long-term outcomes after alloHSCT.
• Understanding trends in cGvHD incidence and outcomes is crucial for improving patient management.

Purpose of the Study:

• To evaluate changes in the incidence and outcomes of cGvHD over three decades following alloHSCT.
• To analyze trends in patient characteristics and treatment modalities influencing cGvHD development and survival.

Main Methods:

• A retrospective study of 102,275 adult patients undergoing first alloHSCT for hematological malignancies between 1990 and 2019.
• Comparison of cGvHD incidence and non-relapse mortality (NRM) across three distinct decades (1990-1999, 2000-2009, 2010-2019).
• Multivariate analysis to identify factors associated with cGvHD incidence and outcomes.

Main Results:

• Overall cGvHD incidence at 48 months showed no significant increase across the three decades (37.3% vs. 44.9% vs. 39.1%).
• Incidence of extensive cGvHD also remained relatively stable across the decades.
• Among patients with cGvHD, NRM at 48 months significantly decreased over time (21.3% to 19.7%, p < 0.001).

Conclusions:

• The incidence of chronic Graft-versus-Host Disease after allogeneic stem cell transplantation has remained stable over the past 30 years.
• Despite unchanged cGvHD incidence, non-relapse mortality has decreased in patients with cGvHD, suggesting improved supportive care and management.
• High NRM persists in patients diagnosed with cGvHD, highlighting the need for continued research and therapeutic advancements.