Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Bone Marrow Transplant. 2017 Aug;52(8):1180-1186. doi: 10.1038/bmt.2017.90. Epub 2017 May 15.
The significance of upper gastrointestinal tract (UGI) acute GVHD (aGVHD) compared with other grade II aGVHD is not clearly defined. We compared the outcomes of patients with grade II aGVHD with or without biopsy-proven UGI involvement in three groups: grade II aGVHD without UGI (n=178), grade II aGVHD with UGI and other sites (n=102) and isolated UGI aGVHD (n=32). The overall response (ORR) to steroids at day 28 differed among the three groups (76, 67 and 91%, respectively, P=0.01), but was only marginally different in direct comparison with those without or with UGI aGVHD (P=0.07) or with isolated UGI aGVHD (P=0.06). In multivariate analysis, as compared with grade II aGVHD patients without UGI involvement, those with UGI involvement and those with isolated UGI aGVHD had similar risks of chronic GVHD, relapse and non-relapse mortality and similar disease-free survival and overall survival. Our data suggest that patients with UGI aGVHD have similar outcomes as those without UGI involvement, supporting the view that UGI aGVHD should still be included as a grade II-defining event.
与其他二级急性移植物抗宿主病（aGVHD）相比，上消化道（UGI）急性 GVHD 的意义尚不清楚。我们比较了三组患者的结局：无 UGI 受累的二级 aGVHD（n=178）、有 UGI 和其他部位受累的二级 aGVHD（n=102）和孤立性 UGI aGVHD（n=32）。三组患者在第 28 天的激素总体反应率（ORR）不同（分别为 76%、67%和 91%，P=0.01），但与无 UGI aGVHD 或有 UGI aGVHD 的患者相比，差异仅略有统计学意义（P=0.07），或与孤立性 UGI aGVHD 患者相比（P=0.06）。多变量分析显示，与无 UGI 受累的二级 aGVHD 患者相比，有 UGI 受累和孤立性 UGI aGVHD 的患者发生慢性 GVHD、复发和非复发死亡率、无病生存和总生存的风险相似。我们的数据表明，UGI aGVHD 患者的结局与无 UGI 受累的患者相似，支持将 UGI aGVHD 仍应包括在二级定义事件中的观点。
