TY - JOUR TI - Long-term outcomes and risk factor analysis of steroid-refractory graft versus host disease after hematopoietic stem cell transplantation AU - Pagliuca, Simona AU - Prata, Pedro Henrique AU - Xhaard, Aliénor AU - Frieri, Camilla AU - Giannoni, Livia AU - Sutra del Galy, Aurelien AU - Brignier, Anne AU - Sicre de Fontbrune, Flore AU - Michonneau, David AU - Dhedin, Nathalie AU - Peffault de Latour, Régis AU - Socié, Gérard AU - Robin, Marie T2 - Bone Marrow Transplantation AB - Steroid-refractory graft versus host disease (GVHD) represents a fearsome complication after allogeneic hematopoietic stem cell transplantation (HSCT). We conducted a retrospective study on outcomes and risk factors associated with acute and chronic steroid-refractory GVHD in a large cohort of 1207 patients receiving HSCT in Saint Louis Hospital between 2007 and 2017. Among patients who developed an acute and/or a chronic GVHD, the cumulative incidences of acute and chronic steroid-refractory disease were 31% and 48%, respectively, at day +100 and 1-year post-HSCT. Through a multivariable analysis we selected several risk factors associated with the development of a steroid-refractory disease. For acute GVHD steroid refractoriness, we identified (1) a very high disease risk index, (2) an unrelated donor, (3) the absence of in vivo T-depletion as GVHD prophylaxis, and (4) a reduced intensity conditioning regimen. For chronic GVHD, (1) the use of peripheral blood stem cells, (2) unrelated donors, and (3) absence of in vivo T-depletion were more likely associated with a steroid-refractory disease. After the construction of a multistate dynamic model, we found that the probability of being alive without relapse after the resolution of all GVHD episodes was about 36% in the long term. DA - 2020/06/25/ PY - 2020 DO - 10.1038/s41409-020-0977-3 DP - www.nature.com SP - 1 EP - 12 LA - en SN - 1476-5365 UR - https://www.nature.com/articles/s41409-020-0977-3 Y2 - 2020/06/25/16:29:45 ER -