Burden on patients

man looking to his right with a neutral expression
man looking to his right with a neutral expression

Patients with cGVHD have poor QOL, regardless of disease severity1

The clinically significant reductions in QOL that can occur with all severity grades (mild through severe) of cGVHD may be underestimated by physicians.1

The burden of cGVHD is multifaceted, with patients experiencing poor QOL and progressive disability1,2,a

circular icon with bar graph showing decreasing quality-of-life (QOL) value

QOL scores across all domains are lower in patients with greater cGVHD severity1

  • Even patients with mild cGVHD symptoms in the lungs, GI tract and joints/fascia
    have clinically meaningful deterioration in physical QOL

aIn a national cross-sectional questionnaire study conducted in Japan, VAS scores were evaluated using 1140 pairs of patient and physician questionnaires. The data were collected from recipients of alloHCT for hematologic disease between 1995 and 2009. The VAS was used to assess the physical, psychological and social QOL of long-term survivors of alloHCT (median time post alloHCT of 7 years) who had various degrees of cGVHD severity.1

Although disability can be progressive,
early intervention can lessen the severity2,3

The potential for progressive disability with cGVHD was demonstrated in an analysis of data from 2 prospective, multicenter, observational studies from the Chronic GVHD Consortium.2

Development/progression of disabilityb following initiation of systemic therapy in patients with mostly moderate or severe cGVHD2

had no disability
at baseline
(n=197)

Of these patients,

50

%

developed a disability.

had disability
at baseline
(n=174)

Of these patients,

50

%

experienced progression of their disability.

bDisability was based on the Flowers criteria at enrollment vs month 18.2

Changes in disability correlated with decreases in human activity profile score—a self-reported measure of physical activity in adult patients—and Karnofsky performance status.2

Progressive disability was associated with2

  • Low ORRs, with 28% of patients achieving CR or PR (P <.0001)
  • The need for additional systemic therapy in 66% of patients (P <.0001)

The 2014 NIH cGVHD Consensus Criteria recommend vigilance in recognizing cGVHD progression and early intervention, which can prevent progression to more severe cGVHD.3

Risk factors for more severe manifestations of cGVHD include4

  • Older age, prior aGVHD, RIC and female donor to male recipient
  • In a retrospective single-center cohort study of patients who were diagnosed with AML and/or MDS and consecutively received a peripheral blood T-cell–depleted NMA alloHCT, moderate to severe cGVHD was associated with5
  • CD19+ cell count ≥82 x 106/kg in graft
  • CD3+ cell count ≥325 x 106/kg in graft
  • HLA antibodies in serum before transplant

A diverse range of patients

benefited from REZUROCK,

an effective and innovative dual inhibitor for the treatment of cGVHD.6

Explore the
rockstar study

aGVHD, acute graft-versus-host disease; alloHCT, allogeneic hematopoietic cell transplant; AML, acute myeloid leukemia; cGVHD, chronic graft-versus-host disease; CR, complete response; GI, gastrointestinal; HLA, human leukocyte antigen; MDS, myelodysplastic syndrome; MOA, mechanism of action; NIH, National Institutes of Health; NMA, nonmyeloablative; ORR, overall response rate; PR, partial response; QOL, quality of life; RIC, reduced-intensity conditioning; VAS, visual analog scale.

References: 1. Kurosawa S, Oshima K, Yamaguchi T, et al. Quality of life after allogeneic hematopoietic cell transplantation according to affected organ and severity of chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2017;23(10):1749-1758. doi:10.1016/j.bbmt.2017.06.011 2. Hamilton BK, Storer BE, Wood WA, et al. Disability related to chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2020;26(4):772-777. doi:10.1016/j.bbmt.2019.10.019 3. Jagasia MH, Greinix HT, Arora M, et al. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host-Disease:I. The 2014 Diagnosis and Staging Working Group report. Biol Blood Marrow Transplant. 2015;21(3):389-401.e1. doi:10.1016/j.bbmt.2014.12.001 4. Afram G, Pérez Simón JA, Remberger M, et al. Reduced intensity conditioning increases risk of severe cGVHD: identification of risk factors for cGVHD in a multicenter setting. Med Oncol. 2018;35(6):79. doi:10.1007/s12032-018-1127-2 5. Kok LMC, Bungener L, de Bock GH, et al. Risk factors associated with the development of moderate to severe chronic graft-versus-host disease after non-myeloablative conditioning allogeneic stem cell transplantation in patients with AML or MDS. Hum Cell. 2020;33(1):243-251. doi:10.1007/s13577-019-00297-7 6. REZUROCK. Package insert. Kadmon Pharmaceuticals, LLC; 2021.