'Real-life' report on the management of chronic GvHD in the Gruppo Italiano Trapianto Midollo Osseo (GITMO)

L Giaccone, G Mancini, N Mordini, G Gargiulo, V De Cecco, S Angelini, M Arpinati, D Baronciani, V Bozzoli, S Bramanti, E Calore, I M Cavattoni, M Cimminiello, A A Colombo, L Facchini, S Falcioni, M Faraci, R Fedele, S Guidi, A P IoriS Marotta, M C Micò, G Milone, F Onida, D Pastore, F Patriarca, M Pini, R Raimondi, A Rovelli, S Santarone, A Severino, C Skert, M T L Stanghellini, C Tecchio, E Vassallo, M Chiarucci, B Bruno, F Bonifazi, A Olivieri

Research output: Contribution to journalArticle

Abstract

Several guidelines have been published about management of chronic GvHD (cGvHD), but the clinical practice still remains demanding. The Gruppo Italiano Trapianto di Midollo Osseo (GITMO) has planned a prospective observational study on cGvHD, supported by a dedicated software, including the updated recommendations. In view of this study, two surveys have been conducted, focusing the management of cGvHD and ancillary therapy in cGvHD, to address the current 'real life' situation. The two surveys were sent to all 57 GITMO centers, performing allografting in Italy; the response rate was 57% and 66% of the interviewed centers, respectively. The first survey showed a great disparity especially regarding steroid-refractory cGvHD, although extracorporeal photo-apheresis resulted as the most indicated treatment in this setting. Another challenging issue was the strategy for tapering steroid: our survey showed a great variance, and this disagreement could be a real bias in evaluating outcomes in prospective studies. As for the second survey, the results suggest that the ancillary treatments are not standardized in many centers. All responding centers reported a strong need to standardize management of cGvHD and to participate in prospective trials. Before starting observational and/or interventional studies, a detailed knowledge of current practice should be encouraged.

Original languageEnglish
Pages (from-to)58-63
Number of pages6
JournalBone Marrow Transplantation
Volume53
Issue number1
DOIs
Publication statusPublished - Jan 2018

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Steroids
Prospective Studies
Blood Component Removal
Homologous Transplantation
Italy
Observational Studies
Therapeutics
Software
Surveys and Questionnaires
Guidelines

Keywords

  • Journal Article

Cite this

Giaccone, L., Mancini, G., Mordini, N., Gargiulo, G., De Cecco, V., Angelini, S., ... Olivieri, A. (2018). 'Real-life' report on the management of chronic GvHD in the Gruppo Italiano Trapianto Midollo Osseo (GITMO). Bone Marrow Transplantation, 53(1), 58-63. https://doi.org/10.1038/bmt.2017.223

'Real-life' report on the management of chronic GvHD in the Gruppo Italiano Trapianto Midollo Osseo (GITMO). / Giaccone, L; Mancini, G; Mordini, N; Gargiulo, G; De Cecco, V; Angelini, S; Arpinati, M; Baronciani, D; Bozzoli, V; Bramanti, S; Calore, E; Cavattoni, I M; Cimminiello, M; Colombo, A A; Facchini, L; Falcioni, S; Faraci, M; Fedele, R; Guidi, S; Iori, A P; Marotta, S; Micò, M C; Milone, G; Onida, F; Pastore, D; Patriarca, F; Pini, M; Raimondi, R; Rovelli, A; Santarone, S; Severino, A; Skert, C; Stanghellini, M T L; Tecchio, C; Vassallo, E; Chiarucci, M; Bruno, B; Bonifazi, F; Olivieri, A.

In: Bone Marrow Transplantation, Vol. 53, No. 1, 01.2018, p. 58-63.

Research output: Contribution to journalArticle

Giaccone, L, Mancini, G, Mordini, N, Gargiulo, G, De Cecco, V, Angelini, S, Arpinati, M, Baronciani, D, Bozzoli, V, Bramanti, S, Calore, E, Cavattoni, IM, Cimminiello, M, Colombo, AA, Facchini, L, Falcioni, S, Faraci, M, Fedele, R, Guidi, S, Iori, AP, Marotta, S, Micò, MC, Milone, G, Onida, F, Pastore, D, Patriarca, F, Pini, M, Raimondi, R, Rovelli, A, Santarone, S, Severino, A, Skert, C, Stanghellini, MTL, Tecchio, C, Vassallo, E, Chiarucci, M, Bruno, B, Bonifazi, F & Olivieri, A 2018, ''Real-life' report on the management of chronic GvHD in the Gruppo Italiano Trapianto Midollo Osseo (GITMO)', Bone Marrow Transplantation, vol. 53, no. 1, pp. 58-63. https://doi.org/10.1038/bmt.2017.223
Giaccone, L ; Mancini, G ; Mordini, N ; Gargiulo, G ; De Cecco, V ; Angelini, S ; Arpinati, M ; Baronciani, D ; Bozzoli, V ; Bramanti, S ; Calore, E ; Cavattoni, I M ; Cimminiello, M ; Colombo, A A ; Facchini, L ; Falcioni, S ; Faraci, M ; Fedele, R ; Guidi, S ; Iori, A P ; Marotta, S ; Micò, M C ; Milone, G ; Onida, F ; Pastore, D ; Patriarca, F ; Pini, M ; Raimondi, R ; Rovelli, A ; Santarone, S ; Severino, A ; Skert, C ; Stanghellini, M T L ; Tecchio, C ; Vassallo, E ; Chiarucci, M ; Bruno, B ; Bonifazi, F ; Olivieri, A. / 'Real-life' report on the management of chronic GvHD in the Gruppo Italiano Trapianto Midollo Osseo (GITMO). In: Bone Marrow Transplantation. 2018 ; Vol. 53, No. 1. pp. 58-63.
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AU - Mordini, N

AU - Gargiulo, G

AU - De Cecco, V

AU - Angelini, S

AU - Arpinati, M

AU - Baronciani, D

AU - Bozzoli, V

AU - Bramanti, S

AU - Calore, E

AU - Cavattoni, I M

AU - Cimminiello, M

AU - Colombo, A A

AU - Facchini, L

AU - Falcioni, S

AU - Faraci, M

AU - Fedele, R

AU - Guidi, S

AU - Iori, A P

AU - Marotta, S

AU - Micò, M C

AU - Milone, G

AU - Onida, F

AU - Pastore, D

AU - Patriarca, F

AU - Pini, M

AU - Raimondi, R

AU - Rovelli, A

AU - Santarone, S

AU - Severino, A

AU - Skert, C

AU - Stanghellini, M T L

AU - Tecchio, C

AU - Vassallo, E

AU - Chiarucci, M

AU - Bruno, B

AU - Bonifazi, F

AU - Olivieri, A

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N2 - Several guidelines have been published about management of chronic GvHD (cGvHD), but the clinical practice still remains demanding. The Gruppo Italiano Trapianto di Midollo Osseo (GITMO) has planned a prospective observational study on cGvHD, supported by a dedicated software, including the updated recommendations. In view of this study, two surveys have been conducted, focusing the management of cGvHD and ancillary therapy in cGvHD, to address the current 'real life' situation. The two surveys were sent to all 57 GITMO centers, performing allografting in Italy; the response rate was 57% and 66% of the interviewed centers, respectively. The first survey showed a great disparity especially regarding steroid-refractory cGvHD, although extracorporeal photo-apheresis resulted as the most indicated treatment in this setting. Another challenging issue was the strategy for tapering steroid: our survey showed a great variance, and this disagreement could be a real bias in evaluating outcomes in prospective studies. As for the second survey, the results suggest that the ancillary treatments are not standardized in many centers. All responding centers reported a strong need to standardize management of cGvHD and to participate in prospective trials. Before starting observational and/or interventional studies, a detailed knowledge of current practice should be encouraged.

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