Trial reportBlood advances2020
Biomarker-guided preemption of steroid-refractory graft-versus-host disease with α-1-antitrypsin.
Trial report in Blood advances, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03459040 (A Proof of Concept Pilot Trial of Alpha-1-Antitrypsin for Pre-Emption Of Steroid-Refractory Acute GVHD), which is not on this map. Cited by 28 papers.
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.
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.
A Proof of Concept Pilot Trial of Alpha-1-Antitrypsin for Pre-Emption Of Steroid-Refractory Acute GVHD
Who cites it
28 citing papers in PubMed, 36 citations in OpenAlex.
- Trial
- Phase 2 study of natalizumab plus standard corticosteroid treatment for high-risk acute graft-versus-host disease.Blood advances · 2023Trial
- 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
- Biomarker-driven strategies and challenges in acute graft-versus-host disease clinical trials.International journal of hematology · 2026Review
- Immediate versus delayed short-course ruxolitinib for acute GVHD prophylaxis after myeloablative allogeneic hematopoietic stem cell transplantation.Frontiers in immunology · 2026Article
- Gastrointestinal acute graft versus host disease: a translational perspective from pathogenesis to precision prevention and treatment.Frontiers in immunology · 2026Review
- Remestemcel-L-rknd (Ryoncil): the first approved cellular therapy for steroid-refractory acute GVHD.Blood · 2025Review
- Prediction and Prognostication of Acute Graft-Versus-Host Disease by MAGIC Biomarkers.American journal of hematology · 2025Review
- Biochemical markers and emerging therapies for intestinal manifestation of graft-versus-host disease.Frontiers in immunology · 2025Review
- Defining and Grading Infections in Clinical Trials Involving Hematopoietic Cell Transplantation: A Report From the BMT CTN Infectious Disease Technical Committee.Transplantation and cellular therapy · 2024Article
- Immunological and homeostatic pathways of alpha -1 antitrypsin: a new therapeutic potential.Frontiers in immunology · 2024Review
- Altered Serum Alpha1-Antitrypsin Protease Inhibition before and after Clinical Hematopoietic Stem Cell Transplantation: Association with Risk for Non-Relapse Mortality.International journal of molecular sciences · 2023Article
- Planning GvHD preemptive therapy: risk factors, biomarkers, and prognostic scores.Hematology. American Society of Hematology. Education Program · 2023Article
- Understanding and treatment of cutaneous graft-versus-host-disease.Bone marrow transplantation · 2023Review
- Article
- Incidence, clinical presentation, risk factors, outcomes, and biomarkers in de novo late acute GVHD.Blood advances · 2023Article
- Review
- Biomarkers for early complications post hematopoietic cell transplantation: Insights and challenges.Frontiers in immunology · 2023Review
- Advances in Imaging of Inflammation, Fibrosis, and Cancer in the Gastrointestinal Tract.International journal of molecular sciences · 2022Review
- Current Definitions and Clinical Implications of Biomarkers in Graft-versus-Host Disease.Transplantation and cellular therapy · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
29 authors at 13 institutions in 4 countries.
Funding
Abstract
Steroid-refractory (SR) acute graft-versus-host disease (GVHD) remains a major cause of nonrelapse mortality (NRM) after allogeneic hematopoietic cell transplantation (HCT), but its occurrence is not accurately predicted by pre-HCT clinical risk factors. The Mount Sinai Acute GVHD International Consortium (MAGIC) algorithm probability (MAP) identifies patients who are at high risk for developing SR GVHD as early as 7 days after HCT based on the extent of intestinal crypt damage as measured by the concentrations of 2 serum biomarkers, suppressor of tumorigenesis 2 and regenerating islet-derived 3α. We conducted a multicenter proof-of-concept "preemptive" treatment trial of α-1-antitrypsin (AAT), a serine protease inhibitor with demonstrated activity against GVHD, in patients at high risk for developing SR GVHD. Patients were eligible if they possessed a high-risk MAP on day 7 after HCT or, if initially low risk, became high risk on repeat testing at day 14. Thirty high-risk patients were treated with twice-weekly infusions of AAT for a total of 16 doses, and their outcomes were compared with 90 high-risk near-contemporaneous MAGIC control patients. AAT treatment was well tolerated with few toxicities, but it did not lower the incidence of SR GVHD compared with controls (20% vs 14%, P = .56). We conclude that real-time biomarker-based risk assignment is feasible early after allogeneic HCT but that this dose and schedule of AAT did not change the incidence of SR acute GVHD. This trial was registered at www.clinicaltrials.gov as #NCT03459040.
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What OpenQuestion holds
Registered trials
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.