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Graft‐versus‐host disease (GVHD)‐specific survival and duration of systemic immunosuppressive treatment in patients who developed chronic GVHD following allogeneic haematopoietic cell transplantation
Author(s) -
Lee JungHee,
Lee JeHwan,
Choi SeongJun,
Kim Shin,
Seol Miee,
Lee YoungShin,
Lee JungShin,
Kim WooKun,
Lee KyooHyung
Publication year - 2003
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2003.04472.x
Subject(s) - medicine , graft versus host disease , transplantation , gastroenterology , hematology , disease , haematopoiesis , immunology , stem cell , biology , genetics
Summary. We investigated graft‐versus‐host disease (GVHD)‐specific survival (GSS) and the duration of systemic immunosuppressive treatment (IST) in 82 patients who developed chronic GVHD following allogeneic haematopoietic cell transplantation (HCT). These two major study endpoints were calculated using the Kaplan–Meier method. Deaths solely due to the relapse of underlying disease or accidental deaths were censored at the time of occurrence for the analysis of GSS. The probability of GSS at 5 years was 74·2%. The median duration of systemic IST for chronic GVHD was 272 d (range: 7–1450), and the probability of withdrawal of systemic IST at 1, 2 and 3 years was 67·3%, 82·4% and 89·0% respectively. Analysis based on a multivariate model showed that a diagnosis other than leukaemia or myelodysplastic syndrome ( P = 0·049), prior occurrence of grade III–IV acute GVHD ( P = 0·021), onset of chronic GVHD before d 120 ( P = 0·013), serum alkaline phosphatase over 120 IU/l ( P = 0·034), and serum bilirubin over 34·2 μmol/l ( P = 0·015) were independent adverse prognostic factors for GSS. Prior occurrence of grade III–IV acute GVHD significantly influenced the duration of systemic IST ( P = 0·048). In conclusion, analyses of GSS and the duration of systemic IST will allow patients with different outcomes to be stratified for appropriate treatment application and will provide important parameters in prospective trials for the treatment of chronic GVHD.