Open AccessCharacteristics and risk of chronic graft-versus-host disease of liver in allogeneic hematopoietic stem cell transplant recipients
Author(s) -
Chien-Ting Chen,
Chun Yu Liu,
Yuan Bin Yu,
Chia Jen Liu,
Liang Tsai Hsiao,
Jyh Pyng Gau,
Tzeon Jye Chiou,
Jing Hwang Liu,
Yao Chung Liu
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0185210
Subject(s) - medicine , hazard ratio , hematopoietic stem cell transplantation , graft versus host disease , retrospective cohort study , liver transplantation , complication , incidence (geometry) , gastroenterology , cohort , liver disease , transplantation , immunology , confidence interval , physics , optics
Chronic graft-versus-host-disease (cGvHD) is a serious complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Among various organ-specific cGvHD, the cGvHD of liver is less well-characterized. In this study, we applied the National Institutes of Health 2014 scoring criteria of cGvHD to analyze a retrospective cohort of 362 allo-HSCT recipients focusing on cGvHD of liver. The overall incidence of liver cGvHD with a score of 3 by 1.5 years post-transplant was 5.8% (21/362). Poor outcome, in terms of overall survival (OS), were observed in patients with scores of 3 liver cGvHD, comparing to those with scores less than 3 (hazard ratio [HR] 2.037, 95% confidence interval [CI] 1.123–3.696, P = 0.019). In multivariate analysis, male gender (HR 4.004, P = 0.042) and chronic hepatitis C virus (HCV) infection status (HR 19.087, P < 0.001) were statistically significant risk factors for scores of 3 liver cGvHD. Our results indicate that liver cGvHD with scores of 3 has a grave prognosis following allo-HSCT, and that HCV carrier status and male are risk factors. Early recognition of this devastating complication might help in prompt immunosuppressive therapy and reducing late poor outcome.