Patient-reported outcomes may help assess disease severity and outcomes in patients with cutaneous chronic graft-vs-host disease, according to a recent study published by Baumrin et al in JAMA Dermatology. The disease is often associated with an impaired quality of life and symptom burden; however, the impact of cutaneous involvement is still unknown. In the multicenter, prospective cohort study, investigators used the Chronic GVHD Consortium to analyze data from 436 patients aged 18 years and older with cutaneous chronic graft-vs-host disease—52.5% (n = 229) of whom had epidermal-type graft-vs-host disease, 30.0% (n = 131) of whom had sclerotic chronic graft-vs-host disease, and 17.4% (n = 76) of whom had combination disease. They then used the Lee Symptom Scale (LSS) skin subscale and the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) instrument to evaluate patient-reported symptom burden and quality of life, respectively. After adjusting for confounders, patients with sclerotic chronic graft-vs-host disease had mean FACT-BMT scores that were 6.1 points worse (95% confidence interval [CI] = 11.7–0.4) and patients with combination disease had mean LSS scores that were 9.0 points worse (95% CI = 4.2–13.8) than the scores of patients with epidermal-type graft-vs-host disease. At diagnosis, clinically meaningful worsening of FACT-BMT and LSS scores resulted in adjusted odds of nonrelapse mortality increasing by a respective 9.1% (95% CI = 2.0%–16.7%) and 16.4% (5.4%–28.5%). Cutaneous chronic graft-vs-host disease may be independently associated with long-term patient-reported outcome impairment and the degree of cutaneous involvement may serve as a prognostic marker for mortality, explained the study authors. They concluded that identifying patients with cutaneous chronic graft-vs-host disease and impaired patient-reported outcomes may help physicians stratify patients by risk, select the most appropriate treatment options, and predict survival outcomes.
March 13, 2024