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The mixed epidermal cell lymphocyte‐reaction is the most predictive factor of acute graft‐versus‐host disease in bone marrow graft recipients
Author(s) -
Bagot Martine,
Mary JeanYves,
Heslan Michèle,
Kuentz Mathieu,
Cordonnier Catherine,
Vernant JeanPaul,
Dubertret Louis,
Levy JeanPaul
Publication year - 1988
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 - 10.1111/j.1365-2141.1988.tb02508.x
Subject(s) - medicine , graft versus host disease , immunology , bone marrow , risk factor , disease , sibling , human leukocyte antigen , lymphocyte , oncology , graft vs host reaction , histocompatibility , gastroenterology , bone marrow transplantation , antigen , psychology , developmental psychology
Risk factors for acute graft‐versus‐host disease (GvHD) remain controversial. We performed uni‐ and multivariate statistical analyses on a series of 37 patients receiving a non‐depleted allogeneic bone marrow transplant from an HLA‐identical sibling donor for a haematological malignancy, in order to identify risk factors for GvHD. Three factors were associated with development of moderate to severe GvHD: a positive mixed epidermal cell‐lymphocyte reaction (MECLR) between donor and recipient, previous pregnancies in female donors and chronic myeloid leukaemia diagnosis. The MECLR was the most important predictive factor, selected in first rank by the stepwise linear discriminant analysis. Combining these three prognostic factors in the jackknifed procedure, we could correctly classify 33/37 patients in two groups: grade 0–I versus grade II–IV acute GvHD. These results should apply to donor selection and to predict donor/recipient pairs at high risk of GvHD who might benefit of bone marrow T‐cell depletion and those at low risk for whom depletion could be avoided.