Fiche publication
Date publication
janvier 2021
Journal
Bone marrow transplantation
Auteurs
Membres identifiés du Cancéropôle Est :
Dr PAGLIUCA Simona
Tous les auteurs :
Pagliuca S, Prata PH, Xhaard A, Frieri C, Giannoni L, Sutra Del Galy A, Brignier A, Sicre de Fontbrune F, Michonneau D, Dhedin N, Peffault de Latour R, Socié G, Robin M
Lien Pubmed
Résumé
Steroid-refractory graft versus host disease (GVHD) represents a fearsome complication after allogeneic hematopoietic stem cell transplantation (HSCT). We conducted a retrospective study on outcomes and risk factors associated with acute and chronic steroid-refractory GVHD in a large cohort of 1207 patients receiving HSCT in Saint Louis Hospital between 2007 and 2017. Among patients who developed an acute and/or a chronic GVHD, the cumulative incidences of acute and chronic steroid-refractory disease were 31% and 48%, respectively, at day +100 and 1-year post-HSCT. Through a multivariable analysis we selected several risk factors associated with the development of a steroid-refractory disease. For acute GVHD steroid refractoriness, we identified (1) a very high disease risk index, (2) an unrelated donor, (3) the absence of in vivo T-depletion as GVHD prophylaxis, and (4) a reduced intensity conditioning regimen. For chronic GVHD, (1) the use of peripheral blood stem cells, (2) unrelated donors, and (3) absence of in vivo T-depletion were more likely associated with a steroid-refractory disease. After the construction of a multistate dynamic model, we found that the probability of being alive without relapse after the resolution of all GVHD episodes was about 36% in the long term.
Mots clés
Factor Analysis, Statistical, Graft vs Host Disease, etiology, Hematopoietic Stem Cell Transplantation, adverse effects, Humans, Retrospective Studies, Risk Factors, Transplantation Conditioning, adverse effects
Référence
Bone Marrow Transplant. 2021 01;56(1):38-49
