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Prognosis of grade 3–4 acute GVHD continues to be dismal

Bone Marrow Transplantation volume 48, pages 1359–1361 (2013)Cite this article

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Survival after hematopoietic cell transplant (HCT) has improved since 2000.1 However, it is unclear whether improvement in survival after grade 3–4 acute GVHD (aGVHD) has paralleled the improvement in survival after HCT. This would be expected, as new immunosuppressive drugs and antimicrobial treatment, and prophylaxis options have become available since 2000. We set out to determine the long-term survival of patients with grade 3–4 aGVHD at our institution after 2000, as well as to review the literature to identify survival of this patient population before and after 2000.

For Methods, see Supplementary Material online. Briefly, recipients of marrow or blood stem cells were studied. Conditioning (always myeloablative) and GVHD prophylaxis typically consisted of fludarabine+BU+antithymocyte globulin (ATG)+MTX+CYA.

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Acknowledgements

This study could not happen without the dedication of data managers, including Maggie Young, Jan McLaughlin and Diana Quinlan and other staff of the Alberta Blood and Marrow Transplant Program, including inpatient and outpatient nurses (lead by Lorraine Harrison, Joanne Leavitt and Naree Ager) and physicians, including Drs M Ahsan Chaudhry, Douglas A Stewart, Nancy Zacarias, Ping Yue, Nizar Bahlis, Chris Brown, Peter Duggan, Michelle Geddes, Lynn Savoie, Mona Shafey, Loree Larratt and Robert Turner. This work was partly funded by Alberta Heritage Foundation for Medical Research and Alberta Cancer Foundation.

Author Contributions

KJ performed chart reviews, analyzed data and wrote the manuscript, JAR, AD, DS, LS and PD critically reviewed the manuscript, and JS conceived the research question and methods, supervised data analyses and extensively edited the manuscript.

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Authors and Affiliations

  1. Division of Hematology and Hematological Malignancies, University of Calgary & Alberta Health Services, Calgary, Alberta, Canada

    K Jamani, J A Russell, A Daly, D Stewart, L Savoie, P Duggan & J Storek

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  1. K Jamani
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  2. J A Russell
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  3. A Daly
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  4. D Stewart
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  5. L Savoie
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  6. P Duggan
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  7. J Storek
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Corresponding author

Correspondence to K Jamani.

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Competing interests

JS received a grant from Genzyme/Sanofi. All other authors declare no conflict of interest.

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Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Jamani, K., Russell, J., Daly, A. et al. Prognosis of grade 3–4 acute GVHD continues to be dismal. Bone Marrow Transplant 48, 1359–1361 (2013). https://doi.org/10.1038/bmt.2013.59

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