Sclerotic cGVHD Patients Show Higher Risk for Outcome Reporting Mismatch
Key Takeaways
More than a third of patients with cutaneous chronic graft-vs-host disease (cGVHD) had discordant treatment response assessments compared to clinicians.
Patients with sclerotic cutaneous cGVHD were at increased risk for both positive and negative discordance.
Patient-reported worsening was a significant predictor of nonrelapse mortality, particularly in those with sclerotic disease.
A new longitudinal cohort study published in JAMA Dermatology showed differences in frequency and importance of discordance between clinician-reported and patient-reported outcomes in cutaneous chronic graft-vs-host disease (cGVHD).
Study authors focused on 489 adults from two observational studies and one randomized clinical trial. Overall, 34.4% of patients had discordant treatment response assessments compared with those of their clinicians. Discordance was more common in patients with sclerotic cGVHD, who were significantly more likely to experience both positive (clinician more favorable) and negative (clinician less favorable) response discrepancies. Adjusted odds ratios for positive and negative clinician discordance in patients with sclerosis were 3.14 (95% CI, 1.41 to 6.95; P = 0.005) and 2.33 (95% CI, 1.19 to 4.56; P = 0.01), respectively.
Clinician- and patient-reported worsening of cGVHD were both associated with increased nonrelapse mortality (NRM; adjusted HR = 2.28; 95% CI, 1.46 to 3.54; P < 0.001, and adjusted HR = 1.86; 95% CI, 1.12 to 3.08; P = 0.02, respectively). Among patients with sclerotic disease, patient-reported worsening was associated with NRM (adjusted HR = 2.00; 95% CI, 1.02 to 3.90; P = 0.04).
“In this cohort study, discordance in treatment response assessments between clinicians and patients was common in cutaneous cGVHD, yet clinician-reported and patient-reported treatment responses were both associated with survival,” the authors wrote. “In patients with sclerosis who were more likely to experience discordance, patient-reported response was a critical treatment end point, and approaches should be developed to bridge discordance.”
Source: Babu V, et al. JAMA Dermatology. 2026. Doi:10.1001/jamadermatol.2025.5545