Effect of PTCy for GvHD prophylaxis on ocular GvHD

Chronic ocular GvHD (oGvHD) affects 40–60% of patients after allo-HSCT and is a major cause of QoL impairment, highlighting a need for strategies to prevent or reduce chronic oGvHD severity.

A single-center, retrospective study examined oGvHD in patients receiving PTCy using data from 63 consecutive patients at the Departments of Ophthalmology and Internal Medicine, University Hospital of Cologne, DE, between 2011 and 2023. All patients underwent regular ophthalmological consultation and received PTCy for GvHD prophylaxis. Of these patients, 42 (66.6%) were diagnosed with acute GvHD and 21 (33.3%) were diagnosed with chronic GvHD during the observation period. Results were published in Bone Marrow Transplant by Menghesha et al.

Key learnings²

In total, 15 of 37 patients who underwent  ≥2 routine ophthalmological examinations after HSCT developed chronic oGvHD (40.54%). Acute oGvHD was present in three patients (18.75%), of which two developed chronic oGVHD consecutively. 

Corneal fluorescein staining (Oxford grade; OD, p = 0.002; OS, p < 0.001), Schirmer’s test (OD, p = 0.018, OS p = 0.045), and OSDI score (p = 0.002) were all significantly different between patients with (n = 15) and without (n = 22) chronic oGvHD.

The proportion of patients developing chronic oGvHD who received PTCy (40.54%) was comparable to the prevalence of chronic oGvHD in a Cologne cohort of 1-year survivors of GvHD (n = 233, 48% chronic oGvHD).

These results demonstrate that the development of chronic oGvHD might be in part independent from the systemic GvHD prophylaxis. Therefore, further studies should consider independent risk factors such as AEs.