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MAGIC biomarkers predict long-term outcomes for steroid-resistant acute GVHD.

ABSTRACT: Acute graft-versus-host disease (GVHD) is treated with systemic corticosteroid immunosuppression. Clinical response after 1 week of therapy often guides further treatment decisions, but long-term outcomes vary widely among centers, and more accurate predictive tests are urgently needed. We analyzed clinical data and blood samples taken 1 week after systemic treatment of GVHD from 507 patients from 17 centers of the Mount Sinai Acute GVHD International Consortium (MAGIC), dividing them into a test cohort (n = 236) and 2 validation cohorts separated in time (n = 142 and n = 129). Initial response to systemic steroids correlated with response at 4 weeks, 1-year nonrelapse mortality (NRM), and overall survival (OS). A previously validated algorithm of 2 MAGIC biomarkers (ST2 and REG3?) consistently separated steroid-resistant patients into 2 groups with dramatically different NRM and OS (P < .001 for all 3 cohorts). High biomarker probability, resistance to steroids, and GVHD severity (Minnesota risk) were all significant predictors of NRM in multivariate analysis. A direct comparison of receiver operating characteristic curves showed that the area under the curve for biomarker probability (0.82) was significantly greater than that for steroid response (0.68, P = .004) and for Minnesota risk (0.72, P = .005). In conclusion, MAGIC biomarker probabilities generated after 1 week of systemic treatment of GVHD predict long-term outcomes in steroid-resistant GVHD better than clinical criteria and should prove useful in developing better treatment strategies.

SUBMITTER: Major-Monfried H

PROVIDER: S-EPMC6014357 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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MAGIC biomarkers predict long-term outcomes for steroid-resistant acute GVHD.

Major-Monfried Hannah H Renteria Anne S AS Pawarode Attaphol A Reddy Pavan P Ayuk Francis F Holler Ernst E Efebera Yvonne A YA Hogan William J WJ Wölfl Matthias M Qayed Muna M Hexner Elizabeth O EO Wudhikarn Kitsada K Ordemann Rainer R Young Rachel R Shah Jay J Hartwell Matthew J MJ Chaudhry Mohammed S MS Aziz Mina M Etra Aaron A Yanik Gregory A GA Kröger Nicolaus N Weber Daniela D Chen Yi-Bin YB Nakamura Ryotaro R Rösler Wolf W Kitko Carrie L CL Harris Andrew C AC Pulsipher Michael M Reshef Ran R Kowalyk Steven S Morales George G Torres Ivan I Özbek Umut U Ferrara James L M JLM Levine John E JE

Blood 20180315 25

Acute graft-versus-host disease (GVHD) is treated with systemic corticosteroid immunosuppression. Clinical response after 1 week of therapy often guides further treatment decisions, but long-term outcomes vary widely among centers, and more accurate predictive tests are urgently needed. We analyzed clinical data and blood samples taken 1 week after systemic treatment of GVHD from 507 patients from 17 centers of the Mount Sinai Acute GVHD International Consortium (MAGIC), dividing them into a tes ...[more]

PMID: 29545329

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MAGIC biomarkers predict long-term outcomes for steroid-resistant acute GVHD.

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MAGIC biomarkers predict long-term outcomes for steroid-resistant acute GVHD.

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