Dr Chen presents statistics on the incidence of chronic graft versus host disease.
Yi-Bin Chen, MD: If there’s one thing we’ve done over the last few decades of transplant, we’ve improved the treatment and the prevention of acute complications. If you look at outcomes, our early nonrelapse mortality has significantly decreased. If you look at large series of patients with either severe or even steroid refractory graft versus host disease [GVHD] through the decades, their outcomes have improved. Some of that is from newer treatments, but some of that is from advances in medicine, better treatment of infections, and supportive care, and understanding how to take care of our patients, or even patient selection. And so, with more patients surviving, I think the burden of chronic graft versus host disease, at least in the last 10 years, has increased.
You can see from this slide that if you look at large registry data, 40% to 50% of patients who undergo modern transplant will develop some sort of chronic graft versus host disease that requires treatment. And getting back to what Catherine said, over two-thirds of these patients had a prior diagnosis of acute [GVHD]. That remains the biggest risk factor one can identify, early reactivity breeds alloreactivity. All these patients with chronic graft versus host diseasewho are treated, as you’ll see from the trial data that we discuss, it’s fairly common, especially now with newer options, for many of our patients to be given multiple therapies after steroids. The majority of our patients, once we treat them for chronic graft versus host disease, do not achieve a complete remission and will require more and more care as time goes on. But I think we’ve definitely made advances in the field, and we’re going to review many of those.
Transcript edited for clarity.