Describing Severe and Non-Severe Chronic Ocular GVHD

By Patrick Daly - Last Updated: October 3, 2022

In an article published in Scientific Reports, researchers described characteristics of ocular graft-versus-host disease (oGVHD) in groups stratified by severe or non-severe oGVHD. Their study found that myelodysplastic syndrome (MDS), lung GVHD, and no history of systemic calcineurin inhibitor use were risk factors for severe oGVHD.

Moreover, the researchers determined that conjunctival scarring (odds ratio [OR], 4.04; P=.045) and persistent epithelial defects (OR, 14.76; P<.001) were independent risk factors for poorer vision outcomes.

The retrospective analysis included 94 patients with oGVHD, of which 25 were classified as severe and 69 as non-severe. Researchers used multivariate logistic regression models to assess factors related to disease severity and vision outcomes. Patients had a mean follow-up of 1641.6 ± 1320.9 days with a mean of 521.9 ± 501.3 days between hematopoietic stem cell transplantation (HSCT) and oGVHD onset.

Reported Features of Severe Ocular GVHD

Reportedly, MDS and lung GVHD were significantly more frequent in the severe group versus the non-severe group at 28.0% versus 7.2% (P=0.014) and 56.0% versus 33.3%, respectively (P=0.041).

Additionally, the severe group had more persistent disease (P=.014) and more frequent flare-ups over a shorter interval compared with the non-severe group.

Notably, the authors’ Kaplan-Meier analysis determined that the proportion of poor vision outcomes at 5 years was higher for patients in the severe group compared with the non-severe group (P<.001). In addition, the rate of 5-year survival was significantly lower in the severe oGVHD group (P=.018).

Overall, the authors described that:

  • MDS, lung GVHD, and no history of calcineurin inhibitor use were significantly associated with severe oGVHD.
  • Persistent epithelial defects and conjunctival scarring were risk factors for poor vision outcomes.
  •  Severe oGVHD appeared to be associated with worse post-HSCT survival outcomes.

“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,” the study’s authors closed.

Related: Prospective Trial Evaluates Montelukast Treatment for Lung cGVHD