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Prognostic factors of chronic graft‐versus‐host disease after allogeneic blood stem‐cell transplantation
Author(s) -
Pavletic Steven Z.,
Smith Lynette M.,
Bishop Michael R.,
Lynch James C.,
Tarantolo Stefano R.,
Vose Julie M.,
Bierman Philip J.,
Hadi Abdul,
Armitage James O.,
Kessinger Anne
Publication year - 2005
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20275
Subject(s) - medicine , graft versus host disease , hematopoietic stem cell transplantation , transplantation , gastroenterology , incidence (geometry) , risk factor , immunology , physics , optics
Allogeneic hematopoietic stem cells in peripheral blood transplantation (alloPBSCT) or bone marrow transplantation (alloBMT) have different biological characteristics which may affect differently prognostic factors for incidence and severity of chronic graft‐versus‐host disease (cGVHD). To determine the prognostic factors of cGVHD in patients receiving alloPBSCT, data on 87 patients who survived at least 100 days after matched related donor myeloablative transplantation were analyzed. Factors significantly associated with higher incidence of cGVHD after alloPBSCT included CMV‐positive donor, acute skin GVHD, and diagnoses other than lymphoma. Factors predictive for poor survival following cGVHD diagnosis included platelet count < 100,000/mm 3 and history of acute liver GVHD. Acute liver GVHD and etoposide in the preparative regimen significantly increased risk of death due to cGVHD after alloPBSCT. All alloPBSCT multivariate models were fit to an independent cohort of comparable matched related donor alloBMT patients ( n = 75). After alloBMT, only acute skin GVHD and diagnoses other than lymphoma retained prognostic significance for predicting cGVHD. Low platelet count was the only variable predictive for poor survival in cGVHD patients after alloBMT. Acute liver GVHD was the only factor that retained prognostic significance for risk of death due to cGVHD after alloBMT. These data suggest there are some cGVHD prognostic factors that may be unique to recipients of alloPBSCT. More studies are needed to determine whether cGVHD prognostic systems should be used interchangeably in patient populations receiving different stem‐cell products. Am. J. Hematol. 78:265–274, 2005. © 2005 Wiley‐Liss, Inc.