ArticleBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation2019
Outcomes and Predictors of Response in Steroid-Refractory Acute Graft-versus-Host Disease.
Article in Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Second-line therapy for patients with steroid-refractory aGVHD: systematic review and meta-analysis of randomized controlled trials.Frontiers in immunology · 2023Pooled it
- Phase II, Open-Label Clinical Trial of Urinary-Derived Human Chorionic Gonadotropin/Epidermal Growth Factor for Life-Threatening Acute Graft-versus-Host Disease.Transplantation and cellular therapy · 2023Trial
- Endothelial activation and damage associated with steroid-refractory aGVHD are counteracted by ruxolitinib.Blood advances · 2026Article
- A phase 1b study on the safety of Wharton's jelly mesenchymal stromal cells in the treatment of acute graft-versus-host disease.Cytotherapy · 2026Article
- The use of mesenchymal stromal cells in steroid-refractory graft-versus-host disease after pediatric hematopoietic stem cell transplantation: a report of the Spanish group of stem cell transplantation (Geth).Bone marrow transplantation · 2025Article
- A higher ratio of IL-2/IL-4 may be an early predictor of acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation.Frontiers in immunology · 2025Article
- Comparison of chimeric mouse-human and humanized anti-CD25 monoclonal antibodies for steroid-refractory acute graft-versus-host disease.Frontiers in immunology · 2025Article
- Bacteroides ovatus alleviates dysbiotic microbiota-induced graft-versus-host disease.Cell host & microbe · 2024Article
- The efficiency of human umbilical cord mesenchymal stem cells as a salvage treatment for steroid-refractory acute graft-versus-host disease.Clinical and experimental medicine · 2023Article
- [Humanized anti-CD25 monoclonal antibody as a salvage therapy for steroid-refractory acute graft-versus-host disease after hematopoietic stem cell transplantation].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2023Article
- Impact of the histologic grade of acute gastrointestinal graft-versus-host disease on outcomes in pediatric patients treated with allogeneic hematopoietic stem cell transplantation.Frontiers in medicine · 2023Article
- Disease progression, treatments, hospitalization, and clinical outcomes in acute GVHD: a multicenter chart review.Bone marrow transplantation · 2022Article
- Diagnostic and therapeutic dilemma in Stevens-Johnson syndrome-like acute graft-versus-host disease after liver transplantation: A case report.Frontiers in immunology · 2022Article
- Acute GVHD: think before you treat.Hematology. American Society of Hematology. Education Program · 2021Review
- Comparative Effectiveness of Remestemcel-L-rknd versus Ruxolitinib in Pediatric Patients with Steroid-Refractory Acute Graft-Versus-Host Disease using Simulated Treatment Comparisons.Journal of health economics and outcomes research · 2021Article
- Elevated plasma phage load as a marker for intestinal permeability in leukemic patients.Medical microbiology and immunology · 2020Article
- A Phase I Study to Evaluate Two Doses of Wharton's Jelly-Derived Mesenchymal Stromal Cells for the Treatment of De Novo High-Risk or Steroid-Refractory Acute Graft Versus Host Disease.Stem cell reviews and reports · 2020Article
- Review
- Prevention and Treatment of Acute Graft-versus-Host Disease in Children, Adolescents, and Young Adults.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2020Review
- A Phase 3, Single-Arm, Prospective Study of Remestemcel-L, Ex Vivo Culture-Expanded Adult Human Mesenchymal Stromal Cells for the Treatment of Pediatric Patients Who Failed to Respond to Steroid Treatment for Acute Graft-versus-Host Disease.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2020Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
The prognosis of steroid-refractory acute graft-versus-host disease (aGVHD) is poor, and predictors of response and survival are unclear. In an exploratory analysis of 203 steroid-refractory aGVHD patients with prospectively collected GVHD data who received antithymocyte globulin, etanercept, or mycophenolate mofetil (MMF) as second-line treatment, we determined the predictors of day 28 response, 2-year overall survival, and 2-year nonrelapse mortality (NRM). To minimize the risk of finding false-positive results, we used least absolute shrinkage and selection operator regression, aggressively eliminating variables that are unlikely to be associated with outcome. Day 28 response to second-line therapy was 38% (complete response, 23%), with a 2-year overall survival of 25% and a 2-year NRM of 62%. Factors associated with response were GVHD prophylaxis, organ involvement, and initial aGVHD to steroid-refractory aGVHD interval. Specifically, compared with cyclosporine/MMF as GVHD prophylaxis, the odds ratio (OR) for calcineurin inhibitor/methotrexate was .8 and for cyclosporine/prednisone .6. The OR for aGVHD to steroid-refractory aGVHD interval ≥ 14 versus <14 days was 1.3. The ORs for skin only involvement and gut or liver only involvement when compared with multiorgan involvement were 1.4 and 1.2, respectively. The only variable associated with worse survival was age, with a hazard ratio (HR) per decade of 1.04 for overall mortality. Similarly, age was the only variable associated with NRM (HR per decade, 1.02). When compared with complete response, no response at day 28 increased the risk of death (HR, 2.4; 95% confidence interval, 1.5 to 3.7). In conclusion, by means of an underused statistical technique in the field of transplantation, we identified predictors of response and survival in steroid-refractory aGVHD. Our results highlight the importance of developing novel treatment strategies because current treatments yield poor outcomes.
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