Evidence map›Paper›PMID 38177221›Full record

ArticleBone marrow transplantation2024

Severity and organ distribution of chronic graft-versus-host disease with posttransplant cyclophosphamide-based versus methotrexate/calcineurin inhibitor-based allogeneic hematopoietic cell transplantation.

Saurabh Chhabra, James H Jerkins, Kathleen Monahan, Aniko Szabo, Nirav N Shah, Sameem Abedin, Lyndsey Runaas, Timothy S Fenske, Marcelo C Pasquini, Bronwen E Shaw and 7 more

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Article in Bone marrow transplantation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.2field-weighted citation impact, top 9% of its field
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

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
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  3. Review
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 1 institution in 1 country.

Saurabh Chhabra *Division of Hematology/Oncology, Department of Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA.ORCID 0000-0001-9117-8696
James H Jerkins *Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.ORCID 0000-0002-2532-0604
Kathleen MonahanDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Aniko SzaboDivision of Biostatistics, Institute for Health & Equity Medical College of Wisconsin, Milwaukee, WI, USA.ORCID 0000-0002-8129-0614
Nirav N ShahDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.ORCID 0000-0002-4336-1071
Sameem AbedinDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Lyndsey RunaasDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Timothy S FenskeDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Marcelo C PasquiniDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Bronwen E ShawDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.ORCID 0000-0003-3317-1896
William R DrobyskiDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.ORCID 0000-0001-7121-6499
Wael SaberDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Anita D'SouzaDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.ORCID 0000-0002-1092-5643
Binod DhakalDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Meera MohanDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.ORCID 0000-0002-6913-6526
Walter LongoDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Mehdi HamadaniDivision of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. mhamadani@mcw.edu.ORCID 0000-0001-5372-510X
Medical College of Wisconsin · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The reduced risk of chronic graft-versus-host-disease (GVHD) with posttransplant cyclophosphamide (ptCy) in the setting of haploidentical related donor and more recently, with HLA-matched related and matched and mismatched unrelated donor allogeneic transplantation has been established. There is, however, paucity of data to show if ptCy impacts chronic GVHD pathogenesis, its phenotype and evolution after HCT regardless of the donor status. We examined the differences in chronic GVHD incidence and presentation in 314 consecutive patients after receiving their first allogeneic transplantation (HCT) using ptCy-based GVHD prophylaxis (ptCy-HCT; n = 120; including 95 with haploidentical related donor) versus conventional calcineurin inhibitor-based prophylaxis (CNI-MUD; n = 194) between 2012 and 2019. The 1-year cumulative incidence of all-grade chronic GVHD and moderate/severe chronic GVHD was 24% and 12%, respectively, after ptCy-HCT and 40% and 23% in the CNI-MUD recipients (p = 0.0003 and 0.007). Multivariable analysis confirmed that use of CNI-based GVHD prophylaxis and peripheral blood stem cell graft as the risk factors for chronic GVHD. The cumulative incidence of visceral (involving ≥1 of the following organs: liver, lungs, gastrointestinal tract, serous membranes) chronic GVHD was significantly higher with CNI-MUD vs. ptCy-HCT (27% vs. 15% at 1 year, p = 0.009). The incidence of moderate/severe visceral chronic GVHD was 20% in CNI-MUD group vs. 7.7% in the ptCy-HCT group at 1 year (p = 0.002). In addition, significantly fewer ptCy-HCT recipients developed severe chronic GVHD in ≥3 organs (0.8%) vs. 8.8% in the CNI-MUD group at 1-year posttransplant (p = 0.004). There was no significant different in relapse, non-relapse mortality, and relapse-free and overall survival between the two groups. Further investigation is needed to confirm that reduced risk and severity of chronic GVHD, less visceral organ distribution with ptCy-HCT leads to improved quality of life.

Indexed as

Bronchiolitis Obliterans SyndromeGraft vs Host DiseaseHematopoietic Stem Cell TransplantationCalcineurin InhibitorsCyclophosphamideHumansMethotrexateQuality of LifeRetrospective StudiesUnrelated DonorsCalcineurin InhibitorsCyclophosphamideMethotrexate

Identifiers

PMID38177221
OpenAlexW4390583144

What OpenQuestion holds

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Registered trials

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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.