High GVHD Prevalence in Travel-Based SCT despite Young Patients and HLA Matching

Area of Science:

• Hematology
• Immunology
• Transplant Medicine

Background:

• Patients undergoing stem cell transplantation (SCT) often travel internationally for treatment and return to countries lacking specialized facilities.
• Data on graft-versus-host disease (GVHD) in international SCT patients returning for post-transplant care is limited.
• This study addresses the scarcity of information regarding GVHD prevalence and risk factors in this specific patient population.

Purpose of the Study:

• To analyze the prevalence of graft-versus-host disease (GVHD) in patients who received stem cell transplantation (SCT) abroad.
• To identify key risk factors associated with GVHD in international SCT recipients.
• To evaluate the incidence of specific GVHD manifestations, such as ocular and lung GVHD.

Main Methods:

• An observational study analyzing data from 91 international SCT patients followed between January 2019 and December 2022.
• Utilized electronic medical records for data collection.
• Employed descriptive statistics, inferential tests, and relative risk calculations with forest plots to assess GVHD prevalence and risk factors.

Main Results:

• The overall prevalence of GVHD was 50% in patients who received allogeneic SCTs.
• Adult recipients (62.2%) had a higher GVHD incidence than pediatric patients (26%).
• Recipients from unrelated identical donors showed a 71% prevalence of GVHD, compared to 50% from related HLA-identical donors. Ocular and lung GVHD showed unexpected prevalence patterns.

Conclusions:

• A high prevalence of GVHD was observed in international SCT patients, despite favorable factors like young age and matched related donors.
• Ocular GVHD was less common than anticipated, and lung GVHD showed weak correlations with known risk factors.
• Larger multicenter studies are recommended to confirm findings and elucidate contributing factors for GVHD in this population.