AbstractMinnesota acute graft versus host disease (AGVHD) risk score is a validated tool to stratify newly-diagnosed patients into standard-risk (SR) and high-risk (HR) groups with ~85% having SR AGVHD. We aimed to identify factors for further risk-stratification within Minnesota SR patients. A single-center, retrospective analysis of consecutive patients between 1/2010 and 12/2014 was performed.

摘要明尼苏达州急性移植物抗宿主病（AGVHD）风险评分是一种有效的工具，可将新诊断患者分为标准风险（SR）和高风险（HR）组，约85%患有SR AGVHD。我们旨在确定明尼苏达州SR患者进一步危险分层的因素。对2010年1月至2014年12月期间的连续患者进行了单中心回顾性分析。

Patients who developed AGVHD within 100 days and treated with systemic corticosteroids were included (N = 416), 356 (86%) of which were Minnesota SR and 60 (14%) had HR AGVHD. Isolated upper gastrointestinal (GI) AGVHD patients had significantly better day 28 and 56 CR/PR rates (90% vs. 72%, p = 0.004) and (83% vs 66%, p = 0.01), respectively, and lower 1-year non-relapse mortality (NRM; 10% vs.

纳入100天内发生AGVHD并接受全身皮质类固醇治疗的患者（N=416），其中356例（86%）为明尼苏达州SR，60例（14%）为HR AGVHD。孤立性上消化道（GI）AGVHD患者第28天和第56天的CR/PR率显着提高（90%比72%，p=0.004）和（83%比66%，p=0.01），1年非复发死亡率较低（NRM；10%比）。

22%; HR 0.4, p = 0.03). Lower GI AGVHD had less favorable outcomes with 1-year NRM of 40% (HR 2.1, p = 0.001), although CR/PR rates were not statistically different. In multivariate analysis, lower GI involvement (HR 2.6, p < 0.001), age ≥ 50 (HR 2.9, p < 0.001) and HCT-CI > 3 (HR 2.1, p = 0.002) predicted for 1-year NRM.

22%；HR 0.4，p=0.03）。较低的GI AGVHD预后较差，1年NRM为40%（HR 2.1，p=0.001），尽管CR/PR率无统计学差异。在多变量分析中，较低的GI受累（HR 2.6，p<0.001），年龄≥50（HR 2.9，p<0.001）和HCT-CI>>3（HR 2.1，p=0.002）预测1年NRM。

Heterogeneity within Minnesota SR patients requires consideration in clinical trials, as distinct outcomes are observed in those with isolated upper GI and lower GI AGVHD, highlighting the importance of stratification in clinical trial design.Highlights.

明尼苏达州SR患者的异质性需要在临床试验中予以考虑，因为在孤立的上消化道和下消化道AGVHD患者中观察到不同的结果，突出了分层在临床试验设计中的重要性。亮点。

Patients with Minnesota standard risk (SR) acute GVHD with isolated upper gastrointestinal involvement have excellent outcomes

明尼苏达州标准风险（SR）急性移植物抗宿主病并孤立性上消化道受累的患者预后良好

Patients with lower gastrointestinal involvement have significantly worse NRM.

下消化道受累的患者NRM明显较差。

GI involvement can further refine the heterogeneity within the Minnesota SR patients.

胃肠道受累可以进一步改善明尼苏达州SR患者的异质性。

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Fig. 1: Distribution of day 28 response according to Minnesota risk group and organ involvement.Fig. 2

图1：根据明尼苏达州风险组和器官受累情况，第28天反应的分布。图2

Data availability

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Datasets of the analysis reported in this study are available from the corresponding author on reasonable request.

本研究报告的分析数据集可根据合理要求从通讯作者处获得。

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Download referencesAuthor informationAuthors and AffiliationsDivision of Hematology, Dalhousie University, Halifax, NS, CanadaCurtis M. MarcouxDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USAAmin M. Alousi, Jin Im, Portia Smallbone, George Chen, Muzaffar Qazilbash, Elizabeth Shpall, Richard C.

下载参考文献作者信息作者和附属机构Dalhousie大学血液学系，哈利法克斯，NS，CanadaCurtis M.MarcouxDepartment of Stem Cell Transplantation and Cellular Therapy，德克萨斯大学安德森癌症中心，德克萨斯州休斯顿，USAAmin M.Alousi，Jin Im，Portia Smallbone，George Chen，Muzaffar Qazilbash，Elizabeth Shpall，Richard C。

Champlin & Rima M. SalibaCenter for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX, USALaquisa C. Hill, Uday Popat, Chitra Hosing, Partow Kebriaei & Amanda OlsonClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USARohtesh MehtaAuthorsCurtis M. MarcouxView author publicationsYou can also search for this author in.

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PubMed Google ScholarContributionsAMA and RMS conceived and designed the study. CM, AMA, LCH, and RMS collected and assembled the data. CM, AMA, and RMS wrote the manuscript. CM, AMA, JI, LCH, PS, UP, CH, PK, AO, RM, GC, MQ, ES, RCC, and RMM interpreted the data, approved the article and are accountable for publication.Corresponding authorCorrespondence to.

。CM，AMA，LCH和RMS收集并组装了数据。CM，AMA和RMS撰写了手稿。CM，AMA，JI，LCH，PS，UP，CH，PK，AO，RM，GC，MQ，ES，RCC和RMM解释数据，批准文章并负责发布。对应作者对应。

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Additional informationPublisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Supplementary informationSupplemental TablesRights and permissionsSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.Reprints and permissionsAbout this articleCite this articleMarcoux, C.M., Alousi, A.M., Im, J.

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et al. Gastrointestinal involvement refines prognosis in minnesota standard risk acute graft-vs.-host disease..

胃肠道受累改善了明尼苏达州标准风险急性移植物抗宿主病的预后。。

Bone Marrow Transplant (2024). https://doi.org/10.1038/s41409-024-02393-1Download citationReceived: 31 January 2024Revised: 02 July 2024Accepted: 06 August 2024Published: 26 August 2024DOI: https://doi.org/10.1038/s41409-024-02393-1Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

骨髓移植（2024）。https://doi.org/10.1038/s41409-024-02393-1Download引文收到日期：2024年1月31日修订日期：2024年7月2日接受日期：2024年8月6日发布日期：2024年8月26日OI：https://doi.org/10.1038/s41409-024-02393-1Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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