@DocMcstuffinsDoc, are you for real ? Your analysis beggars belief…needless to say you quote without a link ..but don’t worry I know the study to which you refer.
So here goes…
https://www.frontiersin.org/articles/10.3389/fped.2023.1194891/fullFirstly, you are quoting a survival rate of 71.4% for acute GVHD, not acute
steroidrefractory GVHD which is our target market. I thought you would have cottoned on that survival rates were much
lower for steroid refractory, when you inadvertently included the fact that “significant mortality risk factors in these patients was a poor response to steroid treatment (p=0.007)
So let me help being updating your presentation with some pertinent facts. Out of 247 children in the study from which you quote, 35 of them suffered from high grade GVHD…what you did not note in your comments was that 12 of the 35 had a good response to steroids as a “first line treatment” …hence the mortality rate of the sr aGVHD patients was considerably higher than the aGVHD percentage you quoted.
The next thing which is worthy of mention is that all patients received GVHD prophylaxis with a combination of cyclosporine A and MMF. I would say this has been about the most meaningful improvement in treatment of sr AGVHD over the last 10 years and has probably reduced by almost 20% the high risk cohort group.
But Doc , the facts from the study you omitted to mention, gives me cause for grave concern about your motives. Firstly of the 10 patients who died ,( many of which predated the availability of Mesoblasts therapy),
none had had the opportunity to include MSCs as part of their treatment protocol as evidenced in the table of non survivors below. It was also noted in the study that most of the patients who died suffered from GI sr aGVHD . In fact, if I remember correctly, 37% of survivors with high grade acute went on to suffer from CGVHD as well.
Now here comes the great reveal, which you just forgot (assuming you actually read the paper you were discussing in your post) regarding the improvement in survival rates. I can’t believe you had the cheek to use a trial, where survival rates improved dramatically because of the use of MSCS and then comment
that “baseline” survival was high without them. By the way ECP has the best results for cutaneous GVHD and unlike MSCS has not successfully completed a phase 3 trial for paediatric sr aGVHD.
SO , Doc, which was it ? Did you fail to read the research properly as to the findings, or were you taking a valid study and providing a misleading view of current rates of mortality which had improved largely because of the very therapy you have been calling into question. I will let HotCopper readers decide now I have provided the link to the study with extracts available as evidence.
Unbelievable ! OP
Please do not rely on the facts or opinions expressed in the above post when making an investment decision.
(20min delay)
