{Reference Type}: Journal Article
{Title}: Real-World Outcomes of Graft-Versus-Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation in Japan: Retrospective Analysis of Transplant Registry Unified Management Program Registry: GVHD outcomes after allo-HSCT.
{Author}: Kanda J;Mitsuyoshi T;Sakurai M;Nishimori H;Murata M;Uchida N;Doki N;Inamoto Y;Nishida T;Tanaka M;Katayama Y;Eto T;Matsuoka KI;Yoshihara S;Sawa M;Kawakita T;Jun G;Kurata M;Ichinohe T;Fukuda T;Teshima T;Atsuta Y;Terakura S;
{Journal}: Transplant Cell Ther
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 1
暂无{DOI}: 10.1016/j.jtct.2024.06.023
{Abstract}: <B>BACKGROUND: </B>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an important therapeutic option for patients with hematological malignancies. However, the development of graft-versus-host disease (GVHD) after allo-HSCT remains a challenge. Although systemic steroid therapy is the established first-line therapy for acute GVHD (aGVHD) and chronic GVHD (cGVHD), many patients are unresponsive or resistant to corticosteroid therapy, and the response is insufficient.<BR><B>OBJECTIVE: </B>To evaluate the clinical characteristics of patients who developed aGVHD and cGVHD after allo-HSCT.<BR><B>METHODS: </B>This noninterventional, retrospective study used large national registry data from the Transplant Registry Unified Management Program. The study included 29,690 patients with hematological diseases who underwent their first allo-HSCT between January 2010 and December 2019. The primary endpoints of this study were the cumulative incidence of aGVHD and cGVHD. The secondary endpoints were overall survival (OS) and non-relapse mortality (NRM) of patients with aGVHD and cGVHD and OS and NRM of patients who received second-line therapy for aGVHD.<BR><B>RESULTS: </B>Of 29,690 patients who underwent allo-HSCT, 2,807, 6,167, 10,556, 774, and 9,339 patients received related bone marrow (RBM), related peripheral blood (RPB), unrelated bone marrow, unrelated peripheral blood (UPB), and unrelated cord blood, respectively. The cumulative incidence of aGVHD (grades II-IV) at 100 days was high after the related and unrelated mismatched transplantation. Furthermore, response rate for the first- and second-line therapy for aGVHD was low in the RBM/RPB-mismatched (59.6%/61.6%) and UPB-mismatched subgroup (45.5%), respectively. The 3-year NRM in patients with aGVHD was high in the RPB and UPB mismatched subgroups (37.9% and 31.2%, respectively).<BR><B>CONCLUSIONS: </B>Developing a novel treatment for steroid-refractory aGVHD is necessary to improve transplant outcomes, particularly for patients undergoing HLA-mismatched transplantation.