Researchers from the National Cancer Institute (NCI) in Maryland have found predictors of chronic graft-versus-host disease (cGVHD) risk, severity, and malignant relapse in patients receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT). These findings, published in Bone Marrow Transplantation, have identified several factors such as the administration of fewer immunosuppressive therapies (ISTs), lower C4 complement levels, and higher body mass index (BMI) to be predictors of relapse.
Treatments such as allo-HSCT have been approved for certain hematological malignancies. Unfortunately, complications such as cGVHD pose serious life-threatening risks to patients. Understanding what predictors may influence the risk of cGVHD allow better understanding and prevention of this complication. In this prospective cross-sectional natural history study (NCT00092235), 247 patients with moderate or severe cGVHD were enrolled. The median time between allo-HSCT and enrollment was 36 months.
The findings indicated multiple risk factors which influence relapse, including how long a patient waits between allo-HSCT and his or her proceeding cGVHD evaluation. Interestingly, classic relapse risk factors such as T-cell depletion, degree of HLA match, female donor to male recipient, and others were not found to be predictive in this cohort. Although further studies are required, these findings may help prevent and develop therapies for cGVHD.
Ruben, C.L., Pirsl, F., Steinberg, S.M. et al. Predictors of hematologic malignancy relapse in patients with advanced chronic graft-versus-host disease. Bone Marrow Transplant (2021). https://doi.org/10.1038/s41409-021-01211-2