Evidence map›Paper›PMID 29133250›Full record

Observational studyBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation2018

Success of Immunosuppressive Treatments in Patients with Chronic Graft-versus-Host Disease.

Stephanie J Lee, Tam D Nguyen, Lynn Onstad, Merav Bar, Elizabeth F Krakow, Rachel B Salit, Paul A Carpenter, Morgani Rodrigues, A Marcie Hall, Barry E Storer and 2 more

Abstract readObservational Study
In one paragraph

Observational study in Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  8. ROCK2 Inhibition With Belumosudil (KD025) for the Treatment of Chronic Graft-Versus-Host Disease.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021
    Trial
  9. Observational
  10. Observational
  11. Article
  12. Review
  13. Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Stephanie J LeeClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medical Oncology, University of Washington, Seattle, Washington. Electronic address: sjlee@fhcrc.org.
Tam D NguyenSchool of Medicine, University of North Carolina, Chapel Hill, North Carolina.
Lynn OnstadClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Merav BarClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medical Oncology, University of Washington, Seattle, Washington.
Elizabeth F KrakowClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medical Oncology, University of Washington, Seattle, Washington.
Rachel B SalitClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medical Oncology, University of Washington, Seattle, Washington.
Paul A CarpenterClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medical Oncology, University of Washington, Seattle, Washington.
Morgani RodriguesCenter for Oncology, Hematology and Bone Marrow Transplantation, Hospital Israelita Albert Einstein, São Paulo, Brazil.
A Marcie HallClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Barry E StorerClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Paul J MartinClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medical Oncology, University of Washington, Seattle, Washington.
Mary E FlowersClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medical Oncology, University of Washington, Seattle, Washington.

Funding

VIRUS-MEDIATED MYELOSUPPRESSIONP01CA018029 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI Evan Newell · 1985 to 2026
$128.4M
Improving Outcomes Assessment in Chronic GVHDR01CA118953 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI LEE, STEPHANIE J · 2011 to 2025
$8.3M
Training and Career Development CoreU54CA163438 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI LEE, STEPHANIE J · 2011 to 2014
$3.7M
Improving Outcomes Assessment in Chronic GVHDU01CA118953 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI LEE, STEPHANIE J · 2007 to 2010
$3.1M
NCI NIH HHS P01 CA018029NCI NIH HHS R01 CA118953NCI NIH HHS U01 CA118953NCI NIH HHS U54 CA163438
6 · The paper itself

Abstract

Moderate to severe chronic graft-versus-host disease (GVHD) is treated with potent immunosuppressive therapy (IST) to modulate the allo-immune response, control symptoms, and prevent further organ damage. We sought to understand the types of treatments used in clinical practice and the likelihood of successful treatment associated with each. A chart review was performed for 250 adult patients at Fred Hutchinson Cancer Research Center enrolled in a prospective observational study. After a median follow-up of 5.6 years for survivors, approximately one-third were still on IST (of whom half were on fourth or greater line of therapy), one-third were alive and off IST, and one-third had relapsed or died. Approximately half of survivors stopped all IST at least once, although half of these restarted IST after a median of 3.4 months (interquartile range, 2.3 to 8.0) off therapy. Successful discontinuation of IST for at least 9 months was associated with myeloablative conditioning (P = .04), more years since transplant (P = .009), and lack of oral (P < .001) and skin (P = .049) involvement compared with those who had to restart IST. We conclude that patients with chronic GVHD usually receive multiple lines and years of IST, with only a third off IST, alive, and free of malignancy at 5 years after chronic GVHD diagnosis. Patients stopping IST should be cautioned to self-monitor and continue close medical follow-up, especially for 3 to 6 months after stopping IST.

Indexed as

Graft vs Host DiseaseHematopoietic Stem Cell TransplantationImmunosuppression TherapyTransplantation ConditioningAdultAgedAllograftsChronic DiseaseDisease-Free SurvivalFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesSurvival RateAllogeneic hematopoietic cell transplantationChronic graft-versus-host diseaseImmunosuppressive treatment

Identifiers

PMID29133250
PMCPMC5826880

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.