Late Acute Graft-versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation

Omer, Aazim K.; Weisdorf, Daniel J.; Lazaryan, Aleksandr; Shanley, Ryan; Blazar, Bruce R.; MacMillan, Margaret L.; Brunstein, Claudio G.; Bejanyan, Nelli; Arora, Mukta

doi:10.1016/j.bbmt.2015.12.020

Cited by 24 publications

(21 citation statements)

References 32 publications

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“…In addition to the GVHD risk factors already discussed, a prior history of aGVHD increases the risk of developing cGVHD (Ferrara & Reddy, ). Clinical patterns of onset of cGVHD include de novo (without prior aGVHD; 9%), progressive (progressing directly from aGVHD; 52%), or quiescent onset (following complete resolution of aGVHD; 39%) (Lee, Vogelsang, & Flowers, ; Omer et al, ). The most frequently affected tissues include the skin, mouth, eyes, liver, and lungs (Jagasia et al, ).…”

Section: Chronic Graft‐versus‐host Diseasementioning

confidence: 99%

Chronic graft‐versus‐host disease: Current management paradigm and future perspectives

et al. 2018

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Chronic GVHD is a serious disease which may be active for years, or even decades, requiring potentially years of immunosuppressive therapies and placing patients at risk for a number of late complications. While the oral cavity has long been recognized to be a prominent target of GVHD, and in particular, chronic GVHD, it must be recognized and appreciated that it is a complex systemic disease with a wide spectrum of clinical manifestations.

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Section: Chronic Graft‐versus‐host Diseasementioning

confidence: 99%

Chronic graft‐versus‐host disease: Current management paradigm and future perspectives

et al. 2018

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“…Graft‐vs‐host Disease (GVHD) is a common complication after allogeneic stem cell transplantation (allo‐HCT) . Historically, the Seattle grading system was widely used for the assessment of chronic GVHD .…”

Section: Introductionmentioning

confidence: 99%

“…The NIH further refined these guidelines in 2014 . In recent years, the prognostic value of the NIH consensus criteria (NCC) has been validated supporting the use of this new system . While most of Bone Marrow Transplant (BMT) centers have adopted these guidelines into their routine clinical assessments, GVHD evaluation requires laborious time‐consuming assessments and can lead to clinician inter‐variability in both diagnosis and scoring of GVHD.…”

Section: Introductionmentioning

confidence: 99%

Establishing a standardized system for review and adjudication of chronic graft‐vs‐host disease data in accordance with the National Institutes Consensus criteria

et al. 2019

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Graft‐vs‐host Disease (GVHD) is a frequent complication following allogeneic stem cell transplantation (allo‐HCT). The National Institute of Health consensus group established new guidelines for the evaluation of chronic GVHD. However, GVHD assessment remains challenging due to its complexity and requirement for laborious evaluation. We, therefore, established a standardized approach for the assessment of chronic GVHD in accordance with the NIH consensus criteria (NCC) guidelines. At a single institution, all allograft recipients were evaluated for GVHD within the first‐year post allo‐HCT following a three‐step workflow (real‐time assessment, consensus review, and documentation). A GVHD adjudication committee was created and a dynamic electronic GVHD data capture form was developed guiding the clinician through a comprehensive review of systems following the NCC guidelines. We found that the assessment and reporting of GVHD reached 100% compliance. The establishment of an institutional GVHD adjudication committee enabled standardized assessment of GVHD. Our workflow can be adopted by other centers to create a similar framework for dedicated GVHD evaluation.

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“…Equally important, they draw our attention to an area where further investigative efforts are needed to improve these patients' life expectancy and quality of life after allogeneic HCT. Omer et al [9] from the University of Minnesota report their experience with late aGVHD in a single-institution study involving matched related, unrelated, and umbilical cord blood allografts. Over a period of 5 years they retrospectively studied 511 patients and observed 248 cases of early-onset and 75 cases of late aGVHD (68/75 with early and late aGVHD).…”

mentioning

confidence: 99%

“…One of the barriers to early detection is failure to Figure 1. Incidence, nonrelapse mortality (NRM), 2-year overall survival (OS), and risk factors for aGVHD and cGVHD [9,12]. Adapted from Omer et al [9].…”

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confidence: 99%

Hosting an Unruly Guest: The Impact of Late Acute and Chronic Graft-versus-Host Disease

Byrne

Savani

2016

Biology of Blood and Marrow Transplantation

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There is no such thing as a free lunch." This adage aptly summarizes the risks associated with allogeneic hematopoietic cell transplantation (HCT). These perils are well described in the medical literature and are quoted to patients considering allogeneic HCT for long-term disease control at centers across the world. Patients that proceed must accept the risks of transplant, particularly graft-versus-host disease (GVHD), which is among the most challenging for clinicians to manage. GVHD is associated with a diminished quality of life, increased healthcare resource utilization, and shortened survival [1]. Several studies have uniformly demonstrated that acute and chronic GVHD fuel transplant-related mortality and negatively impact survival regardless of graft source or conditioning regimen [2-6]. Although our understanding of the pathobiology of GVHD continues to deepen, many knowledge gaps persist, and the optimal management strategy remains an area of active clinical and translational investigation. Enhancing our understanding and optimizing the management of these patients represent an unmet need in the care of patients with hematologic malignancies. The increasing number of allogeneic HCTs performed annually further broadens the scope of this disease. The Center for International Blood and Marrow Transplant Research registry data indicates that the number of allogeneic HCTs has steadily increased over the last 3 decades. A variety of factors, such as advances in supportive care, reduced-intensity conditioning regimens that permit older patients to be transplanted, and the acceptance of alternative stem cell donors are fueling this increase [7]. As a result, allogeneic HCT is performed in a larger and more diverse patient population than ever before. This is underpinned by a

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Late Acute Graft-versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation

Cited by 24 publications

References 32 publications

Chronic graft‐versus‐host disease: Current management paradigm and future perspectives

Chronic graft‐versus‐host disease: Current management paradigm and future perspectives

Establishing a standardized system for review and adjudication of chronic graft‐vs‐host disease data in accordance with the National Institutes Consensus criteria

Hosting an Unruly Guest: The Impact of Late Acute and Chronic Graft-versus-Host Disease

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