Incidence of Acute Graft-Versus-Host Disease and Survival after Allogeneic Hematopoietic Cell Transplantation over Time: A Study from the Transplant Complications and Chronic Malignancies Working Party of the EBMT

Abstract INTRODUCTION Acute graft-versus-host disease (aGvHD) remains a serious complication of allogeneic hematopoietic cell transplantation (HCT) and negatively impacts on patients' outcome. Over recent years improvements in GvHD prophylaxis, HLA typing, donor selection, treatment and supportive care have been achieved. However, it is unknown whether these changes have resulted in improved outcome of patients undergoing allogeneic HCT and particularly in those patients diagnosed with aGvHD and in need of systemic immunosuppressive therapy. METHODS We examined outcome following diagnosis of grades II-IV and grades III-IV aGvHD according to time period and investigated effects according to maximum overall grade of aGvHD. Between 1990 and 2015, 126 838 patients with a median age of 46.4 (range, 18-83.8) years with malignant disease received a first allogeneic sibling (53.9%) or unrelated donor (46.1%) blood (74.5%) or marrow (25.5%) transplant after myeloablative (58.9%) or reduced-intensity (41.1%) conditioning. Sixty-two percent of patients were in complete remission (CR) at HCT. RESULTS Incidences of aGvHD grades II-IV by 100 days significantly (p The median (range) follow-up was 217.6 (213.4-221.7) months, 169.9 (167.6-172.9) months, 129 (127.3-130.8) months, 81.3 (80.5-82.1) months and 29.7 (29.2-30.2) months for 1990-1995, 1996-2000, 2001-2005, 2006-2010 and 2010-2015. For the total study population, 3-year overall survival (OS) significantly (p The OS of patients experiencing aGvHD grades II-IV was 66% at 6 months and decreased to 43% at 36 months after HCT. Survival at 36 months after aGvHD grades II-IV increased significantly (p CONCLUSIONS Incidences of aGvHD grades II-IV and grades III-IV decreased over time and aGvHD-associated survival increased over recent years resulting in improved survival of patients undergoing allogeneic HCT for malignant disease. Disclosures Greinix: Gilead: Speakers Bureau; Roche: Speakers Bureau; Therakos: Speakers Bureau; Novartis: Consultancy, Speakers Bureau; Amgen: Consultancy, Speakers Bureau; Celgene: Consultancy. Chalandon: Roche: Membership on an entity's Board of Directors or advisory committees, Other: Travel costs. Mohty: MaaT Pharma: Consultancy, Honoraria.