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- W4387340133 abstract ": Graft-versus host disease (GvHD) is one of the major limitations to allogeneic hematopoietic stem cell transplantation (HCT). While corticosteroids with calcineurin inhibitors are established first line-therapy for chronic graft-versus host disease (cGvHD), approximately half of cGvHD patients are refractory to corticosteroid therapy. : The goal of the present study was to compare treatment outcomes of patients treated with extracorporeal photophoresis (ECP) and best available therapy (BAT) as third-line or beyond treatment for cGvHD. : Using propensity-score matching (PSM), treatment outcomes were compared between ECP-treated patients (n=74) and a historical cohort of cGvHD patients treated with BAT (n=132). By adjusting for unbalanced risk factors between the groups, including GvHD severity at therapy start, acute GvHD history, and baseline corticosteroid dose, 62 patients were balanced and selected for PSM. : In the PSM cohort, the ECP group showed 70.1% 12 months’ failure-free survival (FFS) rate vs 32.5% in the BAT group (p<0.0001, HR 0.214), and 93.1% 12 months’ overall survival (OS) rate vs 68.1% in the BAT group (p=0.0249, HR 0.3811); multivariate analysis confirmed ECP's superior FFS and OS over BAT. General linear model analysis showed faster tapering of corticosteroids in the ECP vs BAT PSM groups in the first 6 months, and higher rates of prednisone discontinuation; the ECP group had a greater percent prednisone discontinuation by 6%, 14.9% and 22.5% at months 0, 3, and 6, respectively. : The current study demonstrates superior FFS, OS and steroid tapering efficacy for ECP vs BAT as third-line therapy or beyond in cGvHD patients." @default.
- W4387340133 created "2023-10-05" @default.
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- W4387340133 date "2023-10-01" @default.
- W4387340133 modified "2023-10-16" @default.
- W4387340133 title "Propensity score matching analysis comparing the efficacy and steroid tapering benefit of extracorporeal photopheresis to best available therapy in third-line or beyond treatment for chronic GvHD" @default.
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- W4387340133 doi "https://doi.org/10.1016/j.jtct.2023.09.021" @default.
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