Patients with cutaneous graft-vs-host disease may experience significant quality-of-life impairments, with 65% reporting dry skin, 61% tightness, and nearly half struggling with itchiness, according to a recent study.
In the study, published in JAMA Dermatology, researchers examined the health-related quality of life (HRQOL) impacts of cutaneous chronic graft-vs-host disease (GVHD), a significant cause of morbidity and mortality after allogeneic hematopoietic cell transplantation. The research aimed to identify HRQOL domains based on patient perspectives and compare the experiences of patients with epidermal and sclerotic disease subtypes. This single-center qualitative study utilized semistructured interviews and free-listing methods to gather detailed patient-reported data.
From April to September 2023, 31 adults (median age = 61.1 years, interquartile range [IQR] = 52.9–68.7 years) with active cutaneous chronic GVHD were recruited from the University of Pennsylvania. The cohort included 17 males (54.8%) and 14 females (45.2%), with 29% presenting with epidermal disease, 41.9% with sclerotic disease, and 29% with a combination of both. Disease duration varied significantly between the groups, with epidermal cases averaging 43 days (interquartile range = 0–315 days) compared with 744 days (IQR = 592–1342 days) in sclerotic cases (P = .01). Most participants (64.5%) had severe disease by National Institutes of Health skin scoring criteria, with sclerotic and combination subtypes more frequently classified as severe (92.3% and 77.8%, respectively) compared with epidermal cases (11.1%) (P < .001).
Thematic analysis identified five HRQOL domains: skin changes and symptoms, social functioning, psychological and emotional functioning, physical functioning, and general health perceptions. Frequently reported symptoms included dry skin (65%), tightness (61%), and itch (48%), all of which were seen across disease subtypes. Social impairments, such as self-consciousness (52%) and reduced social activity (26%), were prevalent. Psychological effects included frustration (39%), concern about disease progression (29%), and depression (26%). Physical limitations, such as reduced mobility (32%) and difficulty with daily activities (39%), were prominent among sclerotic and combination disease participants.
The study identified significant gaps in patient-reported outcome measures for cutaneous chronic GVHD and emphasized the need for disease-specific tools to assess treatment efficacy and improve clinical care. The findings provided valuable information for future clinical trials and patient-focused therapeutic strategies.
Full disclosures can be found in the published study.