Certain types of graft-versus-host disease may increase risk of death, researcher says

Joseph Pidala, M.D., M.S., assistant member of the Blood and Bone Marrow Transplant and Immunology programs at Moffitt Cancer Center, and colleagues from the Chronic Graft-Versus-Host Disease Consortium have determined that certain gastrointestinal and liver-related types of chronic graft-versus-host disease (GVHD) are associated with worsened quality of life and death.

Their study appeared in the May issue of Biology of Blood and Marrow Transplantation, the official journal of the American Society for Blood and Marrow Transplantation.

GVHD is a complication that can occur when a transplant patient receives stem cells or bone marrow from a donor. The transplanted cells regard the recipient's body as foreign and attack, causing symptoms ranging from nausea and skin rashes to fatigue and pain. Patients with GVHD are prescribed drugs to suppress their immune system to counteract the disease.

The researchers studied data from 567 patients to determine if the characteristics and symptoms of chronic GVHD were associated with major clinical outcomes, such as quality of life and death. They looked specifically at the site of gastrointestinal tract involvement and liver abnormalities.

"We found important differences in outcomes in relation to gastrointestinal and liver involvement," Pidala said. "Those with elevated bilirubin (a substance in bile) levels, higher gastrointestinal scores, or lower gastrointestinal involvement had an increased risk of death under current treatment approaches."

The authors concluded that their findings will help physicians better define a patient's risk of complications and death after chronic GVHD diagnosis and treatment.