The effect of graft-versus-host lymphoma (GVL) is correlated with graft-versus-host disease (GVHD), according to a study presented at the 2021 TCT Meetings of ASTCT & CIBMTR Digital Experience.
Researchers evaluated 2,207 patients with non-Hodgkin lymphomas (NHLs) who received their first allogeneic hematopoietic cell transplantation (alloHCT) from 2003 to 2017. The primary outcome was defined as the impacts of acute GVHD (aGVHD) and chronic GVHD (cGVHD) on lymphoma progression after alloHCT, which the researchers assessed using competing-risks regression models.
The results showed that aGVHD was associated with a reduced risk of progression only in patients who achieved a complete response (CR). aGVHD varied according to lymphoma subtypes; even low-grade aGVHD reduced the risk of progression of mature T/natural killer-cell lymphoma and indolent B-cell lymphomas, whereas grade II or more active aGVHD was needed to reduce a risk of aggressive B-cell lymphoma progression, the researchers noted. Overall, they observed that both pre-transplant active lymphoma status and the unrelated donor source significantly impacted NHL progression.
“Our results supported the presence of GVL effect associated with GVHD; cGVHD/GVL effect was suggested in aggressive NHLs without CR and in indolent NHLs with CR, and acute GVHD/GVL effect was suggested in aggressive NHLs with CR. Considering the high risk of lymphoma progression after alloHCT, it is not the best measure to minimize the risk of GVHD in all [patients with] NHL,” the researchers concluded.
They added that “inducing the optimal GVHD/GVL effect according to each patient’s condition and optimizing the managements of GVHD might be the keys to ameliorate transplant outcomes, since the benefits of GVL effect were often offset by high transplant-related mortality.”
Watanabe M, et al. Impact of Graft-Versus-Host Disease on Lymphoma Progression after Allogeneic Stem Cell Transplantation: Retrospective Analysis from the Adult Lymphoma Working Group of the Japan Society for Hematopoietic Cell Transplantation (JSHCT). Published for the 2021 TCT Meetings of ASTCT & CIBMTR Digital Experience; February 8-12, 2021.