The MAGIC algorithm probability predicts treatment response and long-term outcomes to second-line therapy for acute GVHD
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Le résumé fourni par la source
ABSTRACT: The significance of biomarkers in second-line treatment for acute graft-versus-host disease (GVHD) has not been well characterized. We analyzed clinical data and serum samples at the initiation of second-line systemic treatment of acute GVHD from 167 patients from 17 centers of the Mount Sinai Acute GVHD International Consortium (MAGIC) between 2016 and 2021. Sixty-two patients received ruxolitinib-based therapy, whereas 102 received other systemic agents. In agreement with prospective trials, ruxolitinib resulted in a higher day 28 (D28) overall response Frate than nonruxolitinib therapies (55% vs 31%, P = .003) and patients who received ruxolitinib had significantly lower nonrelapse mortality (NRM) than those who received nonruxolitinib therapies (point estimates at 2-year: 35% vs 61%, P = .002). Biomarker analyses demonstrated that the benefit from ruxolitinib was observed only in patients with low MAGIC algorithm probabilities (MAPs) at the start of second-line treatment. Among patients with a low MAP, those who received ruxolitinib experienced significantly lower NRM than those who received nonruxolitinib therapies (point estimates at 2-year: 12% vs 41%, P = .016). However, patients with high MAP experienced high NRM regardless of treatment with ruxolitinib or nonruxolitinib therapies (point estimates at 2-year: 67% vs 80%, P = .65). A landmark analysis demonstrated that the relationship between the D28 response and NRM largely depends on the MAP level at the initiation of second-line therapy. In conclusion, MAP measured at second-line systemic treatment for acute GVHD predicts treatment response and NRM. The outcomes of patients with high MAP are poor regardless of treatment choice, and ruxolitinib appears to primarily benefit patients with low MAP.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- The MAGIC algorithm probability predicts treatment response and long-term outcomes to second-line therapy for acute GVHD
- Date Crossref
- 28/06/2024
- Éditeur
- American Society of Hematology
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Massachusetts General Hospital pays non établi dans la noticeÉtablissement de santé
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Dana-Farber Cancer Institute pays non établi dans la noticeStructure de recherche
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Icahn School of Medicine at Mount Sinai pays non établi dans la noticeUniversité ou école supérieure
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Universität Hamburg pays non établi dans la noticeUniversité ou école supérieure
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University Medical Center Hamburg-Eppendorf pays non établi dans la noticeÉtablissement de santé
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The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute James Cancer Center pays non établi dans la noticeÉtablissement de santé
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The Ohio State University pays non établi dans la noticeUniversité ou école supérieure
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Children's Hospital of Philadelphia pays non établi dans la noticeOrganisme public
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University of Pennsylvania Abramson Cancer Center pays non établi dans la noticeUniversité ou école supérieure
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Mayo Clinic in Florida pays non établi dans la noticeÉtablissement de santé
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Vanderbilt University Medical Center pays non établi dans la noticeÉtablissement de santé
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Emory University pays non établi dans la noticeUniversité ou école supérieure
Massachusetts General Hospital, Dana-Farber Cancer Institute et Icahn School of Medicine at Mount Sinai, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.