Abstract:
:Acute graft-vs.-host disease (aGvHD) is one of the most frequent causes of transplant-related mortality (TRM) after allogeneic hematopoietic cell transplantation (alloHCT). Its treatment is complex and costly. The aim of this study was to retrospectively analyze the impact of country-specific socioeconomic factors on outcome of patients who experience severe aGvHD. Adults with hematological malignancies receiving alloHCT from either HLA-matched siblings (n = 1,328) or unrelated donors (n = 2,824) developing grade 3 or 4 aGvHD were included. In univariate analysis, the probability of TRM at 2 years was increased for countries with lower current Health Care Expenditure (HCE, p = 0.04), lower HCE as % of Gross Domestic Product per capita (p = 0.003) and lower values of the Human Development Index (p = 0.02). In a multivariate model, the risk of TRM was most strongly predicted by current HCE (HR = 0.76, p = 0.006). HCE >median was also associated with reduced risk of the overall mortality (HR 0.73, p = 0.0006) and reduced risk of treatment failure (either relapse or TRM; HR 0.77, p = 0.004). We conclude that country-specific socioeconomic factors, in particular current HCE, are strongly associated with survival of patients who experience severe aGvHD.
journal_name
Front Immunoljournal_title
Frontiers in immunologyauthors
Frankiewicz A,Peczynski C,Giebel S,Harrington A,Socié G,Niederwieser D,Scheid C,Bornhäuser M,Kröger N,Elmaagacli A,Afanasyev B,Dreger P,Rössig C,Blaise D,Kratz C,Yakoub-Agha I,Kremens B,Niemeyer CM,Wulf G,Blau I,Pdoi
10.3389/fimmu.2020.01537subject
Has Abstractpub_date
2020-07-23 00:00:00pages
1537issn
1664-3224journal_volume
11pub_type
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