P1340: RESPONSE RATES AND PROGNOSTIC FACTORS IN ACUTE GASTROINTESTINAL GRAFT-VERSUS-HOST DISEASE

• DOI: 10.1097/01.hs9.0000848224.29019.3f
• Publication Date: 2022-06-23T15:02:23Z
• Authors: J. Freitas; M. Pimenta; E. Couto; P. Coelho; R. Branca; C. Pinho Vaz; L. Leite; A. Campos
• Keywords: Univariate analysis; Log-rank test

Background: Graft-versus-host disease (GVHD) continues to be the major lethal complication of allogeneic hematopoietic stem cell transplantation (HCT). The standard first-line therapy for acute GVHD is high-dose steroids, but 50% cases are steroid refractory (SR), typically involving gastrointestinal (GI) tract. Unfortunately, there no established second-line which response rates low (20–40%) and overall survival poor, highlighting urgent need better therapies. Aims: Evaluate prognostic factors GI-GVHD patients Methods: was diagnosed clinically and/or histologically graded by MAGIC criteria. Patients whose progressed within 3 days after initiation or who failed improve at least one stage 5 were defined as non-responders. rate (ORR) treatment evaluated retrospectively 4 weeks from first day therapy. Survival outcomes assessed Kaplan-Meier method. In univariate analysis, OS compared using Log rank test. multivariate analyses, Cox proportional hazard regression model performed OS. A p<0.05 considered statistically significant. Results: 351 (pts) submitted HCT 67pts (19.1%) had our institution between 2016 2021. median time onset 37 [7-92]. According grading, 15pts (22.4%) grade 4, 20 (29.9%) 3, 13 (19.4%) 2 19 (28.4%) 1. Although ORR line (corticosteroid therapy) 68.6%, 34pts (50.8%) treated with 2nd therapies, whom 20pts (30%) anti-thymocyte globulin (ATG), 9 pts (13.4%) infliximab 5pts (7.5%) ruxolitinib. ruxolitinib 80%, 55.6% ATG 35%. 4months [0-69] significantly inferior in 3-4 vs 1-2 (2 11 months, p=0.018, fig.1). non-responders, responders (1-year 3.7 41.2%, P<0.001, fig.2). gender, non-responders associated an increased risk death, analysis only independently factor Image:Summary/Conclusion: conclusion, did not respond a worse clinical outcome, two authors contributed equally this work.