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Influence of Age on...
Influence of Age on Acute and Chronic GVHD in Children Undergoing HLA-Identical Sibling Bone Marrow Transplantation for Acute Leukemia : Implications for Prophylaxis
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- Qayed, Muna (author)
- Emory Univ, Sch Med, Aflac Canc & Blood Disorders Ctr, 2015 Uppergate Dr NE, Atlanta, GA, USA
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- Wang, Tao (author)
- Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI, USA; Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI , USA
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- Hemmer, Michael T. (author)
- Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI, USA
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- Spellman, Stephen (author)
- Natl Marrow Donor Program Be Match, Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN, USA
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- Arora, Mukta (author)
- Univ Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN, USA
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- Couriel, Daniel (author)
- Utah Blood & Marrow Transplant Program, Div Hematol & Hematol Malignancies, Dept Internal Med, Salt Lake City, UT USA
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- Alousi, Amin (author)
- Univ Texas MD Anderson Canc Ctr, Div Canc Med, Dept Stem Cell Transplantat, Houston, TX, USA
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- Pidala, Joseph (author)
- H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
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- Abdel-Azim, Hisham (author)
- Univ Southern Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA, USA
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- Aljurf, Mahmoud (author)
- King Faisal Specialist Hosp & Res Ctr, Dept Oncol, Riyadh, Saudi Arabia
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- Ayas, Mouhab (author)
- King Faisal Specialist Hosp & Res Ctr, Dept Pediat Hematol Oncol, Riyadh, Saudi Arabia
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- Bitan, Menachem (author)
- Tel Aviv Sourasky Med Ctr, Dept Pediat Hematol Oncol, Tel Aviv, Israel
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- Cairo, Mitchell (author)
- New York Med Coll, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, Valhalla, NY, USA
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- Choi, Sung Won (author)
- Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI, USA
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- Dandoy, Christopher (author)
- Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Bone Marrow Transplantat & Immune Deficiency, Cincinnati, OH, USA
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- Delgado, David (author)
- Indiana Univ Hosp, Dept Pediat, Indianapolis, IN, USA
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- Gale, Robert Peter (author)
- Imperial Coll London, Dept Med, Div Expt Med, Hematol Res Ctr, London, England
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- Hale, Gregory (author)
- Johns Hopkins All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL, USA
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- Frangoul, Haydar (author)
- TriStar Centennial, Childrens Hosp, Pediat Hematol Oncol, Nashville, TN USA; Sarah Cannon Res Inst, Nashville, TN, USA
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- Kamble, Rammurti T. (author)
- Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX, USA
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- Kharfan-Dabaja, Mohamed (author)
- H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
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- Lehman, Leslie (author)
- Dana Farber Canc Inst, Dept Pediat Hematol Oncol, Boston, MA, USA
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- Levine, John (author)
- Icahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY, USA
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- MacMillan, Margaret (author)
- Univ Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN, USA
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- Marks, David I. (author)
- Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England
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- Nishihori, Taiga (author)
- H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
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- Olsson, Richard (author)
- Karolinska Institutet,Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden
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- Hematti, Peiman (author)
- Univ Wisconsin Hosp & Clin, Dept Med, Div Hematol Oncol Bone Marrow Transplantat, Madison, WI, USA
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- Ringden, Olov (author)
- Karolinska Institutet
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- Saad, Ayman (author)
- Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL, USA
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- Satwani, Prakash (author)
- Columbia Univ, Med Ctr, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, New York, NY, USA
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- Savani, Bipin N. (author)
- Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN, USA
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- Schultz, Kirk R. (author)
- Univ British Columbia, British Columbias Childrens Hosp, Dept Pediat Hematol Oncol & Bone Marrow Transplan, Vancouver, BC, Canada
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- Seo, Sachiko (author)
- East Hosp, Natl Canc Res Ctr, Kashiwa, Chiba, Japan
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- Shenoy, Shalini (author)
- Washington Univ, Dept Pediat Hematol Oncol, St Louis, MO, USA
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- Waller, Edmund K. (author)
- Emory Univ, Winship Canc Inst, Dept Hematol & Med Oncol, Atlanta, GA, USA
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- Yu, Lolie (author)
- Louisiana State Univ, Hlth Sci Ctr, Ctr Canc & Blood Disorders, Div Hematol Oncol, New Orleans, LA, USA
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- Horowitz, Mary M. (author)
- Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI, USA
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- Horan, John (author)
- Emory Univ, Sch Med, Aflac Canc & Blood Disorders Ctr, Atlanta, GA, USA
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(creator_code:org_t)
- Elsevier BV, 2018
- 2018
- English.
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In: Biology of blood and marrow transplantation. - : Elsevier BV. - 1083-8791 .- 1523-6536. ; 24:3, s. 521-528
- Related links:
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http://www.bbmt.org/...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Relapse remains the major cause of mortality after hematopoietic cell transplantation (HCT) for pediatric acute leukemia. Previous research has suggested that reducing the intensity of calcineurin inhibitor-based graft-versus-host disease (GVHD) prophylaxis may be an effective strategy for abrogating the risk of relapse in pediatric patients undergoing matched sibling donor (MSD) HCT. We reasoned that the benefits of this strategy could be maximized by selectively applying it to those patients least likely to develop GVHD. We conducted a study of risk factors for GVHD, to risk-stratify patients based on age. Patients age <18 years with leukemia who received myeloablative, T cell-replete MSD bone marrow transplantation and calcineurin inhibitor-based GVHD prophylaxis between 2000 and 2013 and were entered into the Center for International Blood and Marrow Transplant Research registry were included. The cumulative incidence of grade II-IV acute GVHD (aGVHD) was 19%, that of grade II-IV aGVHD 7%, and that of chronic GVHD (cGVHD) was 16%. Compared with age 13 to 18 years, age 2 to 12 years was associated with a lower risk of grade II-IV aGVHD (hazard ratio [HR], .42; 95% confidence interval [CI], .26 to .70; P = .0008), grade II-IV aGVHD (HR, .24; 95% CI, .10 to .56; P = .001), and cGVHD (HR, .32; 95% CI, .19 to .54; P < .001). Compared with 2000-2004, the risk of grade II-IV aGVHD was lower in children undergoing transplantation in 2005-2008 (HR, .36; 95% CI, .20 to .65; P = .0007) and in 2009-2013 (HR, .24; 95% CI. .11 to .53; P = .0004). Similarly, the risk of grade III-IV aGVHD was lower in children undergoing transplantation in 2005-2008 (HR, .23; 95% CI, .08 to .65; P = .0056) and 2009-2013 (HR, .16; 95% CI, .04 to .67; P = .0126) compared with those doing so in 2000-2004. We conclude that aGVHD rates have decreased significantly over time, and that children age 2 to 12 years are at very low risk for aGVHD and cGVHD. These results should be validated in an independent analysis, because these patients with high-risk malignancies may be good candidates for trials of reduced GVHD prophylaxis.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Immunologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Immunology in the medical area (hsv//eng)
Keyword
- GVHD
- Matched sibling donor transplantation
- Children
- Recipient age
- Leukemia
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Qayed, Muna
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Wang, Tao
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Hemmer, Michael ...
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Spellman, Stephe ...
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Arora, Mukta
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Couriel, Daniel
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show more...
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Alousi, Amin
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Pidala, Joseph
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Abdel-Azim, Hish ...
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Aljurf, Mahmoud
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Ayas, Mouhab
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Bitan, Menachem
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Cairo, Mitchell
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Choi, Sung Won
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Dandoy, Christop ...
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Delgado, David
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Gale, Robert Pet ...
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Hale, Gregory
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Frangoul, Haydar
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Kamble, Rammurti ...
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Kharfan-Dabaja, ...
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Lehman, Leslie
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Levine, John
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MacMillan, Marga ...
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Marks, David I.
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Nishihori, Taiga
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Olsson, Richard
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Hematti, Peiman
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Ringden, Olov
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Saad, Ayman
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Satwani, Prakash
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Savani, Bipin N.
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Schultz, Kirk R.
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Seo, Sachiko
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Shenoy, Shalini
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Waller, Edmund K ...
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Yu, Lolie
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Horowitz, Mary M ...
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Horan, John
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Immunology in th ...
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Biology of blood ...
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Uppsala University
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Karolinska Institutet