Researchers examining the clinical stage and grade of acute graft-versus-host disease (GVHD) in 1,723 patients at the onset of treatment with systemic steroids have developed a new GVHD risk score that predicts response to initial therapy, survival, and transplant-related mortality. The score was determined by the number of involved organs and severity of GVHD at onset, which stratified patients into high-risk (HR) or standard-risk (SR) cohorts. The overall response (complete response/partial response) rate 28 days after initiation of steroid therapy for acute GVHD was significantly lower in the 269 patients with HR-GVHD than in the 1,454 patients with SR-GVHD: 44% vs. 68%, respectively (p<0.001). The researchers concluded that patients with HR-GVHD are candidates for studies investigating new treatment approaches, and patients with SR-GVHD are candidates for studies investigating less toxic therapy.
MacMillan ML, et al. Biol Blood Marrow Transplant
Patient-level summary of this study (PDF)