In a study published in Scientific Reports, researchers reported risk factors for long-term clinical outcomes and poor final visual prognosis in patients with ocular graft vs host disease (oGVHD).
The study authors conducted a retrospective cohort study to investigate the long-term clinical outcomes and predictive factors associated with poor visual outcomes in patients with chronic oGVHD following allogeneic hematopoietic stem cell transplantation (HSCT). The team used multivariate logistic regression to examine the relationships between potential risk factors, oGVHD severity, and poor vision outcomes.
A total of 94 patients, who were classified as having severe (n = 25) and non-severe (n = 69) oGVHD, were included in the study. The mean patient age was 40.93 ± 16.62 years. Over half (58.5%) of patients were male. The mean duration between HSCT and oGVHD onset was 521.9 ± 501.3 days, and the mean total follow-up duration was 1641.6 ± 1320.9 days.
The researchers found that the disease activity pattern was more frequently persistent in the severe oGVHD group than in the non-severe oGVHD group (48% vs 22%; P =.014). They also observed that flare-up episodes were more frequent (2.64 ± 1.99 vs 1.60 ± 0.85; n=.034) and occurred over shorter intervals (8.56 ± 10.68 vs 17.25 ± 14.69 months; n=.007) in the severe oGVHD group compared with the non-severe oGVHD group.
Using multivariate analysis, the team found that severe oGVHD was associated with the presence of myelodysplastic syndrome (MDS; odds ratio [OR], 5.50; P =.019), lung GVHD
(OR, 4.17; P =.041), and no history of systemic calcineurin inhibitor use (OR, 3.95; P =.047). They also found that poor vision outcomes were associated with the presence of conjunctival scarring (OR, 4.04; P =.045) and persistent epithelial defects (OR, 14.76; P <.001).
With Kaplan-Meier analyses, the researchers found that 5-year rates of poor vision outcomes were higher and 5-year survival rates were lower in the severe oGVHD group than in the non-severe oGVHD group (P <.001 and P =.018, respectively).
“In conclusion, our results suggest that frequent and careful follow-up of patients with these risk factors is recommended for proper management of chronic oGVHD in the real-world setting,” wrote the researchers.
The primary limitations of the study were the retrospective design, relatively small sample size, and other uncontrolled factors, such as treatment regimens and pre-HSCT ocular status.
Yoon HJ, Song GY, Yoon KC. Long-term clinical outcomes and predictive factors in patients with chronic ocular graft-versus-host disease. Sci Rep. 2022;12(1):12985. doi:10.1038/s41598-022-17032-2