cGvHD incidence, initial presentation, and risk factors: Results from the CATCH study

Results from the prospective, multicenter, observational Close Assessment and Testing for Chronic Graft-versus-Host Disease (CATCH) study (NCT04188912), evaluating the incidence and early presenting signs of chronic graft-versus-host disease (cGvHD) in 208 patients across 7 hematopoietic stem cell transplantation (HSCT) centers, were published in Blood Advances by Pidala et al. Outcomes included the cumulative incidence of cGvHD and cGvHD onset features. 

Key data: The cumulative incidence of any cGvHD was 54% (95% confidence interval [CI], 46–61) at 24 months post-HSCT, and 38% (95% CI, 30–45) of patients with cGvHD required systemic immunosuppressive therapy (IST). De novo, interrupted, and progressive cGvHD were reported in 40%, 26%, and 34% of patients, respectively. Organ involvement at onset included mouth (42%), eye (41%), skin (32%), liver (17%), lung (11%), gastrointestinal (GI; 9%), and joints/fascia (5%). In the final multivariate analysis, donor cytomegalovirus (CMV) seropositivity, non-post-transplant cyclophosphamide (PTCy)-based acute GvHD (aGvHD) prophylaxis, serial skin/mouth/patient-reported outcomes (PROM) scores, and symptom burden measures were associated with the subsequent development of cGvHD requiring IST (Harrell's C-statistic, 0.84).

Key learning: These findings highlight that cGvHD remains a frequent complication post-HSCT. Associations between cGvHD requiring IST and factors such as CMV positivity, prophylaxis type, and serial changes in organ scores and symptom burden may provide insights for early risk assessment and the development of future preemptive approaches.