Clinical features and risk factors analysis of acute graft-versus-host disease in patients with related HLA-haploidentical non T cell-depleted in vitro peripheral hematopoietic stem cell transplantation.

Wenjing Xue; China Urumqi 830054; Ming Jiang; China Urumqi 830054; Meng Tian; China Urumqi 830054; Xianlin Duan; China Urumqi 830054; Jianhua QU; China Urumqi 830054; Hailong Yuan; China Urumqi 830054; Jianli XU; China Urumqi 830054; Bingzhao Wen; China Urumqi 830054; Ling LI; China Urumqi 830054; Yichun Wang; China Urumqi 830054; Ying Liu; China Urumqi 830054; Xinyou Wang; China Urumqi 830054; Haizhou Cao; China Urumqi 830054

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Clinical features and risk factors analysis of acute graft-versus-host disease in patients with related HLA-haploidentical non T cell-depleted in vitro peripheral hematopoietic stem cell transplantation.

Author: Wenjing XUE ^{1
,

2
,

3} ; Urumqi 830054, CHINA. ; Ming JIANG ¹ ; Urumqi 830054, CHINA. ; Meng TIAN ¹ ; Urumqi 830054, CHINA. ; Xianlin DUAN ¹ ; Urumqi 830054, CHINA. ; Jianhua QU ¹ ; Urumqi 830054, CHINA. ; Hailong YUAN ¹ ; Urumqi 830054, CHINA. ; Jianli XU ¹ ; Urumqi 830054, CHINA. ; Bingzhao WEN ¹ ; Urumqi 830054, CHINA. ; Ling LI ¹ ; Urumqi 830054, CHINA. ; Yichun WANG ¹ ; Urumqi 830054, CHINA. ; Ying LIU ¹ ; Urumqi 830054, CHINA. ; Xinyou WANG ¹ ; Urumqi 830054, CHINA. ; Haizhou CAO ¹ ; Urumqi 830054, CHINA.
Author Information

1. Hematologic Disease Center, First Affiliated Hospital of Xinjiang Medical University
2. Xinjiang Uygur Autonomous Region Research Institute of Hematology
3. Urumqi 830054, China.
Publication Type:Journal Article
MeSH: Disease-Free Survival; Graft vs Host Disease; Haplotypes; Hematopoietic Stem Cell Transplantation; Histocompatibility Testing; Humans; In Vitro Techniques; Incidence; Peripheral Blood Stem Cell Transplantation; Risk Factors; Siblings; T-Lymphocytes
From: Chinese Journal of Hematology 2014;35(12):1100-1106
CountryChina
Language:Chinese
Abstract:
OBJECTIVETo study the clinical features of acute graft-versus-host disease (aGVHD) and its risk factors for the related HLA-haploidentical non T cell-depleted in vitro peripheral hematopoietic stem cell transplantation (RHNT-PBSCT).
METHODSFrom July 2002 to December 2012, 104 patients who underwent the RHNT-PBSCT were enrolled to analyze the incidences, location and its risk factors of aGVHD, compared with those of the 103 patients who received the HLA-matched sibling non T cell-depleted in vitro PBSCT (MSNT-PBSCT) in the same period.
RESULTS(1)The cumulative incidence of aGVHD in the RHNT-PBSCT group was significantly higher than the MSNT-PBSCT group [(56.2±4.7)% vs (34±3.6)%, P<0.05], but the cumulative incidences of II-IV and III-IVgrade aGVHD had no significant difference between the two groups[(39.5±2.9)% vs (21.2±5.4)%, P>0.05; (12.6±4.1)% vs (10.8±2.4)%, P>0.05]. (2)The cumulative incidence of cutaneous aGVHD was significantly higher in RHNT-PBSCT group than that in MSNT-PBSCT group [(42.3±3.2)% vs (17.5±2.3)%, P<0.05]. The cumulative incidences of liver and gastrointestinal aGVHD between the two groups had no significant difference [(7.7±2.1)% vs (12.6±3.4)%, P>0.05; (16.3±4.5)% vs (10.3±2.5)%, P>0.05]. (3)The 3-year disease free survival (DFS) and overall survival(OS) of RHNT-PBSCT group and MSNT-PBSCT group were (63±5.5)%, (65.2±4.7)% and (74.2±5.4)%, (77.4±5)% respectively, without significance (P=0.078, P=0.052). (4)aGVHD occurrence with HLA haplotype (P=0.003) and matched loci (P=0.002) were significantly correlated by univariate analysis. Multivariate analysis showed that only the HLA typing is a risk factor for aGVHD (HR=1.891, P=0.03).
CONCLUSIONAlthough the incidence of total aGVHD in RHNT-PBSCT protocol is higher than that in MSNT-PBSCT, but there was no significance in severe aGVHD and cutaneous aGVHD was the common type, which indicates that RHNT-PBSCT protocol is feasible.