What Is the Impact of GVHD on Myelofibrosis Relapse After HSCT?

Nicolaus Kröger, MD, of the University Medical Center Hamburg-Eppendorf, discusses a study on graft-versus-host disease (GVHD) and its impact on relapse in patients with myelofibrosis undergoing hematopoietic stem cell transplantation (HSCT).

The major aim of HSCT is graft-versus-leukemia effect, in which the patient’s new immune system targets the leukemic cells, according to Dr. Kröger.

However, there is a risk of GVHD after transplantation, in which the new immune cells can attack the patient’s healthy body. As Dr. Kröger noted, severe GVHD can affect patients’ quality of life and can lead to death or complication.

The study included 341 patients uniformly treated with HSCT. Ninety-three (27%) patients had mild GVHD, 86 (25%) had moderate GVHD, and 36 (11%) had severe chronic GVHD.

Dr. Kröger and colleagues found that patients with mild GVHD have a lower-risk of relapse than those who did not experience any GVHD.

“This highlighted that not every GVHD is detrimental for patients, and that patients should not be completely afraid of GVHD,” Dr. Kröger said. “It’s actually the art of performing the transplantation to control GVHD to a certain extent to harness the graft-versus-leukemia effect and then avoid the risk of relapse in these patients.”