Steroid-refractory acute graft-versus-host disease graded III-IV in pediatric patients. A mono-institutional experience with a long-term follow-up
© 2020 Wiley Periodicals LLC..
aGvHD remains a major obstacle to successful HSCT. We report our experience on steroid-refractory aGvHD III and IV from 1989 to 2017. Ninety patients with aGvHD III or IV were stratified according to the HSCT year: 1989-1998, 1999-2007, and 2008-2017 and to aGvHD extension (GvHD III vs IV) and finally the probability of OS, RI, and TRM was calculated accordingly. aGvHD III patients had a substantial improvement over time: day 100 OS raised from 64% (95% CI 39-89) in the first cohort to 100% in the latest (P = .022), and it was mainly due to a reduction of TRM (it was 28% [95% CI 12-65] in the first cohort to 0% in the latest (P = .01). The aGvHD IV patients did not present a significant improvement. Day 100 OS was 42% (95% CI 16-68) in the first group and 54% (95% CI 25-83) in the year 2008-2017 (P = NS), and the day-100 TRM was very similar (it was 57% [95% CI 36-90] in the first cohort and 45% [95% CI 23-89] in the latest (P = NS). We report significant improvements in OS and TRM in patients diagnosed with grade III aGvHD. Patients with the most severe aGvHD appear to have no or fewer benefits on long-term outcomes.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2020 |
---|---|
Erschienen: |
2020 |
Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
---|---|
Enthalten in: |
Pediatric transplantation - 24(2020), 7 vom: 01. Nov., Seite e13806 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Berger, Massimo [VerfasserIn] |
---|
Links: |
---|
Themen: |
Children |
---|
Anmerkungen: |
Date Completed 07.10.2021 Date Revised 07.10.2021 published: Print-Electronic Citation Status MEDLINE |
---|
doi: |
10.1111/petr.13806 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM314178627 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM314178627 | ||
003 | DE-627 | ||
005 | 20231225152157.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2020 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1111/petr.13806 |2 doi | |
028 | 5 | 2 | |a pubmed24n1047.xml |
035 | |a (DE-627)NLM314178627 | ||
035 | |a (NLM)32844519 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Berger, Massimo |e verfasserin |4 aut | |
245 | 1 | 0 | |a Steroid-refractory acute graft-versus-host disease graded III-IV in pediatric patients. A mono-institutional experience with a long-term follow-up |
264 | 1 | |c 2020 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 07.10.2021 | ||
500 | |a Date Revised 07.10.2021 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © 2020 Wiley Periodicals LLC. | ||
520 | |a aGvHD remains a major obstacle to successful HSCT. We report our experience on steroid-refractory aGvHD III and IV from 1989 to 2017. Ninety patients with aGvHD III or IV were stratified according to the HSCT year: 1989-1998, 1999-2007, and 2008-2017 and to aGvHD extension (GvHD III vs IV) and finally the probability of OS, RI, and TRM was calculated accordingly. aGvHD III patients had a substantial improvement over time: day 100 OS raised from 64% (95% CI 39-89) in the first cohort to 100% in the latest (P = .022), and it was mainly due to a reduction of TRM (it was 28% [95% CI 12-65] in the first cohort to 0% in the latest (P = .01). The aGvHD IV patients did not present a significant improvement. Day 100 OS was 42% (95% CI 16-68) in the first group and 54% (95% CI 25-83) in the year 2008-2017 (P = NS), and the day-100 TRM was very similar (it was 57% [95% CI 36-90] in the first cohort and 45% [95% CI 23-89] in the latest (P = NS). We report significant improvements in OS and TRM in patients diagnosed with grade III aGvHD. Patients with the most severe aGvHD appear to have no or fewer benefits on long-term outcomes | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a children | |
650 | 4 | |a severe acute graft-versus-host disease | |
650 | 4 | |a survival | |
650 | 7 | |a Glucocorticoids |2 NLM | |
650 | 7 | |a Immunosuppressive Agents |2 NLM | |
700 | 1 | |a Pessolano, Rosanna |e verfasserin |4 aut | |
700 | 1 | |a Carraro, Francesca |e verfasserin |4 aut | |
700 | 1 | |a Saglio, Francesco |e verfasserin |4 aut | |
700 | 1 | |a Vassallo, Elena |e verfasserin |4 aut | |
700 | 1 | |a Fagioli, Franca |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Pediatric transplantation |d 1997 |g 24(2020), 7 vom: 01. Nov., Seite e13806 |w (DE-627)NLM097406473 |x 1399-3046 |7 nnns |
773 | 1 | 8 | |g volume:24 |g year:2020 |g number:7 |g day:01 |g month:11 |g pages:e13806 |
856 | 4 | 0 | |u http://dx.doi.org/10.1111/petr.13806 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 24 |j 2020 |e 7 |b 01 |c 11 |h e13806 |