Acute graft‐versus‐host disease in pediatric allogeneic hematopoietic stem cell transplantation. Single‐center experience during 10 yr

a‐ G v HD may complicate allogeneic HSCT . In this retrospective single‐center study, we evaluated incidence and risk factors of a‐ G v HD in 197 consecutive allogeneic pediatric HSCT s applying G lucksberg and NIH a‐Gv HD classifications. Among 179 eligible transplants, the cumulative incidence of grade 0–I a‐ G v HD was 48% and grade II – IV was 52%. None of the considered variables significantly influenced the incidence of grade II – IV a‐ G v HD . Malignancy and myeloablation were associated with an increased risk of classic a‐ G v HD (p < 0.01). Seventy‐two percentage of children are alive, with a significant difference in OS and TRM between grade 0 and I vs. grade II and IV a‐ G v HD ; this observation was reproduced in the non‐malignant setting, while only a disparity in TRM was evidenced in children with malignancy. In our experience, the incidence of a‐ G v HD was similar, regardless of donor type. Myeloablation and malignant disease represented the only risk factors for classic a‐ G v HD . Our results highlight the need for a better prevention of this complication in the non‐malignant setting.