TY - JOUR
T1 - Risk factors for acute graft-versus-host disease after allogeneic blood stem cell transplantation
AU - Przepiorka, Donna
AU - Smith, Terry L.
AU - Folloder, Jody
AU - Khouri, Issa
AU - Ueno, Naoto T.
AU - Mehra, Rakesh
AU - Körbling, Martin
AU - Huh, Yang O.
AU - Giralt, Sergío
AU - Gajewski, James
AU - Donato, Michele
AU - Cleary, Karen
AU - Claxton, David
AU - Braunschweig, Ira
AU - Van Besien, Koen
AU - Andersson, Borje S.
AU - Anderlini, Paolo
AU - Champlin, Richard
PY - 1999/8/15
Y1 - 1999/8/15
N2 - We evaluated demographic characteristics and graft composition as risk factors for acute graft-versus-host disease (GVHD) in 160 adult recipients of HLA-identical allogeneic blood stem cell transplants. The patients received a median nucleated cell dose of 7.9 x 108/kg and median C34+ cell dose of 5.6 x 106/kg. GVHD prophylaxis consisted of cyclosporine (CSA) and steroids, tacrolimus (FK506) and steroids, or FK506 and methotrexate. Grades 2 to 4 GVHD occurred in 31% (95% CI, 23% to 39%), and grades 3 to 4 GVHD in 14% (95% CI, 8% to 20%). In univariate analyses, GVHD prophylaxis with CSA and high CD34+ cell doses were significant risk factors for grades 2 to 4 GVHD, but diagnosis, age, use of total body irradiation, donor sex, female donor for male recipient, donor parity, donor alloimmunization, viral serology, nucleated cell dose, CD3+ cell dose, and CD56+ cell dose did not alter the incidence of GVHD significantly. With a CD34+ cell dose less than 8 x 106 CD34+ cells/kg, the risk of grades 2 to 4 GVHD was significantly higher for those who received CSA (39%, 95% CI, 21% to 47%) in comparison with those on FK506 (18%, 95% CI, 10% to 26%) (P = .03), but GVHD prophylaxis regimen had less impact with a higher CD34+ cell dose (overall grades 2 to 4 GVHD rate 52%, 95% CI, 37% to 67%). GVHD prophylaxis and CD34+ cell dose are independent risk factors for acute GVHD after allogeneic blood stem cell transplantation.
AB - We evaluated demographic characteristics and graft composition as risk factors for acute graft-versus-host disease (GVHD) in 160 adult recipients of HLA-identical allogeneic blood stem cell transplants. The patients received a median nucleated cell dose of 7.9 x 108/kg and median C34+ cell dose of 5.6 x 106/kg. GVHD prophylaxis consisted of cyclosporine (CSA) and steroids, tacrolimus (FK506) and steroids, or FK506 and methotrexate. Grades 2 to 4 GVHD occurred in 31% (95% CI, 23% to 39%), and grades 3 to 4 GVHD in 14% (95% CI, 8% to 20%). In univariate analyses, GVHD prophylaxis with CSA and high CD34+ cell doses were significant risk factors for grades 2 to 4 GVHD, but diagnosis, age, use of total body irradiation, donor sex, female donor for male recipient, donor parity, donor alloimmunization, viral serology, nucleated cell dose, CD3+ cell dose, and CD56+ cell dose did not alter the incidence of GVHD significantly. With a CD34+ cell dose less than 8 x 106 CD34+ cells/kg, the risk of grades 2 to 4 GVHD was significantly higher for those who received CSA (39%, 95% CI, 21% to 47%) in comparison with those on FK506 (18%, 95% CI, 10% to 26%) (P = .03), but GVHD prophylaxis regimen had less impact with a higher CD34+ cell dose (overall grades 2 to 4 GVHD rate 52%, 95% CI, 37% to 67%). GVHD prophylaxis and CD34+ cell dose are independent risk factors for acute GVHD after allogeneic blood stem cell transplantation.
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U2 - 10.1182/blood.v94.4.1465
DO - 10.1182/blood.v94.4.1465
M3 - Article
C2 - 10438735
AN - SCOPUS:0033566990
SN - 0006-4971
VL - 94
SP - 1465
EP - 1470
JO - Blood
JF - Blood
IS - 4
ER -