Chronic GVHD Consortium CATCH Study: Incidence, initial presentation and risk factors for chronic GVHD development

Area of Science:

• Hematology
• Immunology
• Oncology

Background:

• Chronic graft-versus-host disease (GVHD) remains a significant complication after allogeneic hematopoietic stem cell transplantation (HCT).
• Despite declining incidence, up to 30% of survivors develop chronic GVHD, impacting long-term outcomes.
• Understanding current incidence and early manifestations is crucial for developing effective early treatment strategies.

Purpose of the Study:

• To determine the current incidence of chronic GVHD and its subtypes after allogeneic HCT.
• To identify the earliest presenting signs and symptoms of chronic GVHD across various organs.
• To explore risk predictors and patient-reported outcomes associated with chronic GVHD development and severity.

Main Methods:

• A prospective, multi-center observational study involving 208 subjects undergoing allogeneic HCT.
• Regular assessments including clinician evaluations, patient-reported measures (Lee Symptom Score, PROMIS), and biologic sample collection.
• Data collection occurred pre-HCT, at regular intervals post-HCT, and at the time of chronic GVHD diagnosis.

Main Results:

• The cumulative incidence of any chronic GVHD was 54% by 24 months post-HCT; 38% required systemic immune suppressive therapy (IST).
• Commonly affected organs at onset included mouth (42%), eye (41%), and skin (32%), with predominantly mild to moderate severity.
• Risk factors for requiring IST included baseline donor/recipient CMV positivity, non-PTCY prophylaxis, and changes in specific symptom scores.

Conclusions:

• Current chronic GVHD incidence remains substantial, with significant organ involvement at presentation.
• Early detection of specific symptoms and identification of risk factors like CMV status are key for timely intervention.
• This study provides valuable data for future biomarker research and clinical trials targeting early chronic GVHD therapy.