OBJECTIVES: Chronic graft-versus-host-disease (cGVHD) deteriorates survival and quality of life after allogeneic hematopoietic cell transplantation (alloHCT). We evaluated the incidence and risk factors for this complication based on a single-center experience. METHODS: 255 consecutive patients, aged 29 (10-56) years, who survived without disease progression after alloHCT performed between 1992-2003 were included in the analysis. The preparative regimen was myeloablative, donors were either related (n=177) or unrelated volunteers (URD-HCT) (n=78). RESULTS: Cumulative incidence of the overall and extensive cGVHD equaled 48% and 22%, respectively. In a multivariate analysis the following factors were associated with increased risk of cGVHD: preceding grade II-IV acute GVHD, recipient age > or =40 years, URD-HCT, the diagnosis of chronic myeloid leukemia (CML) or myelodysplastic syndrome, and CD3 cell dose 50 x 10(6)/kg. Similar factors, excluding recipient age contributed to increased risk of extensive cGVHD, however, the cut-point for CD3 cell dose was 100 x l0(6)/kg and the use of steroids for acute GVHD prophylaxis was found an additional risk factor. In a CML subgroup the risk of cGVHD was increased for patients previously treated with interferon. CONCLUSIONS: Various recipient-, donor-, and procedure-related factors are related to the risk of cGVHD. Individualized treatment and modification of risk factors may contribute to improved outcome.
OBJECTIVES: Chronic graft-versus-host-disease (cGVHD) deteriorates survival and quality of life after allogeneic hematopoietic cell transplantation (alloHCT). We evaluated the incidence and risk factors for this complication based on a single-center experience. METHODS: 255 consecutive patients, aged 29 (10-56) years, who survived without disease progression after alloHCT performed between 1992-2003 were included in the analysis. The preparative regimen was myeloablative, donors were either related (n=177) or unrelated volunteers (URD-HCT) (n=78). RESULTS: Cumulative incidence of the overall and extensive cGVHD equaled 48% and 22%, respectively. In a multivariate analysis the following factors were associated with increased risk of cGVHD: preceding grade II-IV acute GVHD, recipient age > or =40 years, URD-HCT, the diagnosis of chronic myeloid leukemia (CML) or myelodysplastic syndrome, and CD3 cell dose 50 x 10(6)/kg. Similar factors, excluding recipient age contributed to increased risk of extensive cGVHD, however, the cut-point for CD3 cell dose was 100 x l0(6)/kg and the use of steroids for acute GVHD prophylaxis was found an additional risk factor. In a CML subgroup the risk of cGVHD was increased for patients previously treated with interferon. CONCLUSIONS: Various recipient-, donor-, and procedure-related factors are related to the risk of cGVHD. Individualized treatment and modification of risk factors may contribute to improved outcome.
Authors: Frances T Hakim; Sarfraz Memon; Ping Jin; Matin M Imanguli; Huan Wang; Najibah Rehman; Xiao-Yi Yan; Jeremy Rose; Jacqueline W Mays; Susan Dhamala; Veena Kapoor; William Telford; John Dickinson; Sean Davis; David Halverson; Haley B Naik; Kristin Baird; Daniel Fowler; David Stroncek; Edward W Cowen; Steven Z Pavletic; Ronald E Gress Journal: J Immunol Date: 2016-09-30 Impact factor: 5.422
Authors: Carrie L Kitko; Sophie Paczesny; Gregory Yanik; Thomas Braun; Dawn Jones; Joel Whitfield; Sung W Choi; Raymond J Hutchinson; James L M Ferrara; John E Levine Journal: Biol Blood Marrow Transplant Date: 2008-07 Impact factor: 5.742
Authors: Barbara Zawilinska; Jolanta Kopec; Slawa Szostek; Beata Piatkowska-Jakubas; Aleksander B Skotnicki; Magdalena Kosz-Vnenchak Journal: Med Sci Monit Date: 2011-08
Authors: Caroline M Wernicke; Thomas Gp Grunewald; Juenger Hendrik; Selim Kuci; Zyrafete Kuci; Ulrike Koehl; Ingo Mueller; Michaela Doering; Christina Peters; Anita Lawitschka; Hans-Jochem Kolb; Peter Bader; Stefan Burdach; Irene von Luettichau Journal: Int Arch Med Date: 2011-08-15