All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional.
Introducing
Now you can personalise
your GvHD Hub experience!
Bookmark content to read later
Select your specific areas of interest
View content recommended for you
Find out moreThe GvHD Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the GvHD Hub cannot guarantee the accuracy of translated content. The GvHD Hub and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.
Bookmark this article
Graft-versus-host disease (GvHD) is a major limitation and complication after allogeneic stem cell transplantation (allo-SCT). Acute GvHD (aGvHD) is associated with a high symptom burden including pain and reduced quality of life (QOL). Chronic GvHD (cGvHD) occurs in 30−70% of patients and is a leading cause of morbidity and nonrelapse mortality post allo-SCT. Due to GvHD-associated symptom burden, the majority of patients score low on QOL measures.
The impact of aGvHD and cGvHD severity and steroid response on the QOL of patients post allo-SCT was recently studied in real-world cross-sectional surveys, which were conducted by Hammad et al. (aGvHD) and Lachance et al. (cGvHD).1,2
To assess the QOL of GvHD, data on disease severity and its impact on patients were collected from hematology-oncologists. Patients were also required to fill in the information using the EQ-5D-5L assessment tool. The EQ-5D-5L form consisted of a descriptive questionnaire and a visual analog scale (VAS) where patients could rate their QOL on a 7-point scale ranging from very good to very poor, and reported their current symptoms. These responses were analyzed by GvHD grade as per National Institutes of Health (NIH) criteria, and steroid response as reported by the physicians. An outline of the study method is presented in Figure 1.
Figure 1. An outline of the methods used for data collection from patients and physicians, and analysis using the EQ-5D-5L assessment tool*
cGvHD, chronic graft-versus-host disease; aGvHD, acute graft-versus-host disease; QOL, quality of life; VAS, visual analog scale.
*Adapted from Hammad et al.1 and Lachance et al.2
†Data was collected from five European countries: France, Germany, Italy Spain, and UK.
Table 1 below depicts the patient demographics in the study.
Table 1. Patient demographics*
Patients |
Age, median (range), years |
Gender, % |
Median time since diagnosis, days |
Responsive |
Refractory |
|
---|---|---|---|---|---|---|
M |
F |
|||||
cGvHD |
|
|
|
|
|
|
aGvHD |
|
|
|
|
|
|
cGvHD severity |
|
|
|
|
|
|
aGvHD severity |
|
|
|
|
|
|
cGvHD |
|
|
|
|
|
|
aGvHD |
|
|
|
|
|
|
aGvHD, acute graft-versus-host disease; cGvHD, chronic graft-versus-host disease. |
Figure 2. Patient QOL decreased with an increase in GvHD severity*
aGvHD, acute graft-versus-host disease; cGvHD, chronic graft-versus-host disease; QOL, quality of life; VAS, visual analogue scale.
*Data derived from Hammad et al.1 and Lachance et al.2
Table 2. EQ-5D-5L responses by individual dimension*
Problem score |
None, |
Slight, |
Moderate, |
Severe, |
Extreme, |
---|---|---|---|---|---|
cGvHD |
|
|
|
|
|
aGvHD |
|
|
|
|
|
aGvHD, acute graft-versus-host disease; cGvHD, chronic graft-versus-host disease. |
Figure 3. Symptom burden increased with GvHD severity*
aGvHD, acute graft-versus-host disease; cGvHD, chronic graft-versus-host disease.
*Data derived from Hammad et al.1 and Lachance et al.2
Table 3. Mean number of reported psychosocial problems and mean score of total problems in cGvHD and aGvHD patients*
Severity |
Mean number of reported problems† |
Mean total problem score‡ |
||
---|---|---|---|---|
cGvHD |
aGvHD |
cGvHD |
aGvHD |
|
Mild |
7.1 |
6.8 |
8.1 |
9.1 |
aGvHD, acute graft-versus-host disease; cGvHD, chronic graft-versus-host disease. |
Figure 4. Activity impairment for cGvHD and aGvHD patients as per severity of the disease and steroid response*
aGvHD, acute graft-versus-host disease; cGvHD, chronic graft-versus-host disease.
*Data derived from Hammad et al.1 and Lachance et al.2
This study captures the real-life experiences of patients with aGvHD and cGvHD. In both disease states, the QOL is impaired for these patients along with an increase in symptom burden and cost of treatment. These results highlight the need for better symptom control with improved first- and second-line treatments.
Subscribe to get the best content related to GvHD delivered to your inbox