Reduced intensity conditioning increases risk of severe cGVHD: identification of risk factors for cGVHD in a multicenter setting

Reduced intensity conditioning increases risk of severe cGVHD : identification of risk factors for cGVHD in a multicenter setting

Chronic graft-versus-host disease (cGVHD) remains a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Aim is to identify risk factors for the development of cGVHD in a multicenter setting. Patients transplanted between 2000 and 2006 were analyzed (n = 820). Donors were HLA-identical siblings (57%), matched unrelated donors (30%), and HLA-A, B or DR antigen mismatched (13%). Reduced intensity conditioning (RIC) was given to 65% of patients. Overall incidence of cGVHD was 46% for patients surviving more than 100 days after HSCT (n = 747). Older patient age [HR 1.15, p < 0.001], prior acute GVHD [1.30, p = 0.024], and RIC [1.36, p = 0.028] increased overall cGVHD. In addition, RIC [4.85, p < 0.001], prior aGVHD [2.14, p = 0.001] and female donor to male recipient [1.80, p = 0.008] increased the risk of severe cGVHD. ATG had a protective effect for both overall [0.41, p < 0.001] and severe cGVHD [0.20, p < 0.001]. Relapse-free survival (RFS) was impaired in patients with severe cGVHD. RIC, prior aGVHD, and female-to-male donation increase the risk of severe cGVHD. ATG reduces the risk of all grades of cGVHD without hampering RFS. GVHD prophylaxis may be tailored according to the risk profile of patients.

Perez Simon, Jose AntonioUniv Seville, CSIC, Hosp Univ Virgen del Rocio, Dept Hematol,Inst Biomed Sevilla IBIS, Seville, Spain (author)
Remberger, MatsKarolinska Univ Hosp Huddinge, Ctr Allogene Stem Cell Transplantat, Stockholm, Sweden (author)
Caballero-Velazquez, TeresaUniv Seville, CSIC, Hosp Univ Virgen del Rocio, Dept Hematol,Inst Biomed Sevilla IBIS, Seville, Spain (author)
Martino, RodrigoHosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain (author)
Luis Pinana, JoseHosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain;Hosp Clin Univ, Dept Hematol, Valencia, Spain (author)
Ringden, OlleKarolinska Institutet (author)
Esquirol, AlbertHosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain (author)
Lopez-Corral, LuciaHosp Univ Salamanca IBSAL, Dept Hematol, Salamanca, Spain (author)
Garcia, IreneHosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain (author)
Lopez-Godino, OrianaHosp Univ Salamanca IBSAL, Dept Hematol, Salamanca, Spain (author)
Sierra, JordiHosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain (author)
Caballero, DoloresHosp Univ Salamanca IBSAL, Dept Hematol, Salamanca, Spain (author)
Ljungman, PerKarolinska Institutet (author)
Vazquez, LourdesHosp Univ Salamanca IBSAL, Dept Hematol, Salamanca, Spain (author)
Hägglund, HansUppsala universitet,Hematologi(Swepub:uu)hanha689 (author)
Karolinska InstitutetUniv Seville, CSIC, Hosp Univ Virgen del Rocio, Dept Hematol,Inst Biomed Sevilla IBIS, Seville, Spain (creator_code:org_t)

In:Medical Oncology: Springer Science and Business Media LLC35:61357-05601559-131X

By the author/editor: Afram, Gabriel; Perez Simon, Jos ...; Remberger, Mats; Caballero-Velazq ...; Martino, Rodrigo; Luis Pinana, Jos ...; show more...; Ringden, Olle; Esquirol, Albert; Lopez-Corral, Lu ...; Garcia, Irene; Lopez-Godino, Or ...; Sierra, Jordi; Caballero, Dolor ...; Ljungman, Per; Vazquez, Lourdes; Hägglund, Hans; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Hematology

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