Effect of graft-versus-host disease on relapse and survival in 100 patients after allogeneic hematopoietic stem cell transplantation.
- Author:
Xue-Rong DENG
1
;
Han-Yun REN
;
Xi-Nan CEN
;
Li-Hong WANG
;
Ze-Yin LIANG
;
Wen-Sheng WANG
;
Zhi-Xiang QIU
;
Jin-Ping OU
;
Wei-Lin XU
;
Mang-Ju WANG
;
Yuan LI
;
Yue YIN
Author Information
1. Department of Hematology, Peking University First Hospital, Beijing 100034, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Child;
Child, Preschool;
Disease-Free Survival;
Female;
Graft vs Host Disease;
etiology;
mortality;
Hematopoietic Stem Cell Transplantation;
adverse effects;
mortality;
Humans;
Incidence;
Male;
Middle Aged;
Recurrence;
Retrospective Studies;
Risk Factors;
Young Adult
- From:
Journal of Experimental Hematology
2009;17(4):994-998
- CountryChina
- Language:Chinese
-
Abstract:
The study was aimed to investigate the incidences and risk factors of acute and chronic graft-versus-host diseases (GVHD) and to clarify their effects on relapse and survival of recipients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The clinical data of 100 cases of allo-HSCT were retrospectively analyzed. The incidences and risk factors of aGVHD and cGVHD, relapse and survival were studied. The results showed that 31 cases developed aGVHD of II - IV grade (34.4%) and 14 cases developed aGVHD of III - IV grade (17.7%). HLA matched or mismatched did not show significant difference in the development of aGVHD of II - IV grade (p > 0.05). Previous occurrence of aGVHD was the risk factor for cGVHD (HR = 2.303, p = 0.088). The female was a favorable factor for cGVHD (HR = 0.401, p = 0.055). The relapse rate was lower in patients who developed cGVHD. The development of aGVHD of II - IV grade was the risk factor for overall survival (p < 0.05). The mortality of patients with aGVHD of III - IV grade and mortality of patients with aGVHD of 0 - I grade were 81.0% and 35.7% respectively, there was very significant difference between them (p = 0.000). In conclusion, till now GVHD and graft-versus-leukemia (GVL) effect can not be separated. The positive effect of GVL could be counteracted by GVHD-related mortality. It is necessary to prevent and control the development of severe aGVHD. The development of local cGVHD may be beneficial to the long-term disease-free survival of patients after allo-HSCT.
