Long-term Outcomes Impaired by Cutaneous Chronic Graft-vs-Host Disease

Sclerotic and combination-type disease showed the highest impairment.

New analysis results indicate that cutaneous chronic graft-vs-host disease (GVHD) was linked with impaired long-term patient-reported outcomes (PROs).

Researchers for the 9-center study conducted by the Chronic GVHD Consortium examined the association between different types of chronic GVHD and PROs among individuals 18 years of age and older with a diagnosis of CVHD requiring immunosuppression and with skin involvement during the study period. Spanning from August 2007 to April 2012, the research team followed participants (n = 436) until December 2020.

According to the study results, sclerotic chronic GVHD was independently associated with worse quality of life compared to epidermal-type chronic GVHD. Specifically, patients with sclerotic disease had significantly lower Functional Assessment of Cancer Therapy–Bone Marrow Transplantation (FACT-BMT) scores compared to those with epidermal disease. Additionally, patients with combination disease exhibited the highest symptom burden, as indicated by higher Lee Symptom Scale (LSS) skin subscale scores.

The researchers also reported that clinically meaningful worsening in PROs at the time of chronic GVHD diagnosis was associated with increased odds of nonrelapse mortality. Specifically, patients experiencing significant declines in FACT-BMT or increases in LSS skin subscale scores had higher odds of nonrelapse mortality, highlighting the prognostic value of PRO impairment in predicting mortality risk.

"The results of this cohort study demonstrated that skin chronic GVHD was independently associated with long-term PRO impairment, with sclerotic and combination disease carrying the highest morbidity," the team concluded in the study. "The degree of impairment at skin chronic GVHD diagnosis was a prognostic marker for mortality. Therefore, PROs could be useful for risk stratification and treatment selection in clinical practice and clinical trials."

Source: Baumrin E, Shin DB, Mitra N, et al. Patient-Reported Outcomes and Mortality in Cutaneous Chronic Graft-vs-Host Disease. JAMA Dermatology. Published online February 28, 2024. doi:https://doi.org/10.1001/jamadermatol.2023.6277