# The prognostic value of colonoscopy grading for acute graft-versus-host disease in patients with malignant hematological disorders after unrelated cord blood transplantation

## TL;DR

This study shows that less severe colonoscopy findings in blood cancer patients after a specific transplant are linked to better treatment outcomes and survival.

## Contribution

The study demonstrates that colonoscopy grading is an independent predictor of treatment response and survival in patients with intestinal acute graft-versus-host disease.

## Key findings

- Patients with mild colonoscopy grades (I/II) had significantly higher treatment response rates than those with severe grades (III/IV).
- Mild colonoscopy grades were associated with a 70.4% two-year survival rate compared to 34.8% in severe cases.
- Colonoscopy grading was identified as an independent prognostic factor for treatment outcomes and survival.

## Abstract

探讨肠镜下分级对非血缘脐血移植（UCBT）后出现肠道急性移植物抗宿主病（IT-aGVHD）的恶性血液病患者的预后评估价值。

收集2016年6月至2023年6月在安徽省立医院进行UCBT后出现激素耐药的IT-aGVHD患者50例，比较肠镜下黏膜损伤较轻组（27例，肠镜下分级为Ⅰ、Ⅱ级）和较重组（23例，肠镜下分级为Ⅲ、Ⅳ级）患者IT-aGVHD治疗的有效率、生存率等，回顾性分析影响患者预后的因素。

轻症组、重症组患者在肠镜检查后28 d有效率分别为92.6％和47.8％（P<0.001），56 d有效率分别为81.5％和39.1％（P＝0.002），最优有效率分别为92.6％和65.2％（P＝0.040），差异均有统计学意义。多因素分析发现，肠镜下分级是影响IT-aGVHD治疗有效率的独立危险因素。轻症组、重症组患者肠镜检查后2年的总生存率分别为70.4％（95％CI 52.0％～88.8％）和34.8％（95％CI 14.8％～54.8％），差异有统计学意义（P＝0.003）。多因素分析显示，肠镜下分级、巨细胞病毒感染状态、二线治疗方案及患者的年龄是影响生存的独立危险因素。

肠镜下黏膜损伤程度较轻组（Ⅰ、Ⅱ级）患者的治疗有效率和预后优于损伤程度较重组（Ⅲ、Ⅳ级）。