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Influence of Age on...
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Qayed, MunaEmory Univ, Sch Med, Aflac Canc & Blood Disorders Ctr, 2015 Uppergate Dr NE, Atlanta, GA, USA
(author)
Influence of Age on Acute and Chronic GVHD in Children Undergoing HLA-Identical Sibling Bone Marrow Transplantation for Acute Leukemia : Implications for Prophylaxis
- Article/chapterEnglish2018
Publisher, publication year, extent ...
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Elsevier BV,2018
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-351083
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-351083URI
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https://doi.org/10.1016/j.bbmt.2017.11.004DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:137861689URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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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 and genre
Added entries (persons, corporate bodies, meetings, titles ...)
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Wang, TaoMed Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI, USA; Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI , USA
(author)
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Hemmer, Michael T.Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI, USA
(author)
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Spellman, StephenNatl Marrow Donor Program Be Match, Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN, USA
(author)
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Arora, MuktaUniv Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN, USA
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Couriel, DanielUtah Blood & Marrow Transplant Program, Div Hematol & Hematol Malignancies, Dept Internal Med, Salt Lake City, UT USA
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Alousi, AminUniv Texas MD Anderson Canc Ctr, Div Canc Med, Dept Stem Cell Transplantat, Houston, TX, USA
(author)
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Pidala, JosephH Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
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Abdel-Azim, HishamUniv Southern Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA, USA
(author)
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Aljurf, MahmoudKing Faisal Specialist Hosp & Res Ctr, Dept Oncol, Riyadh, Saudi Arabia
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Ayas, MouhabKing Faisal Specialist Hosp & Res Ctr, Dept Pediat Hematol Oncol, Riyadh, Saudi Arabia
(author)
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Bitan, MenachemTel Aviv Sourasky Med Ctr, Dept Pediat Hematol Oncol, Tel Aviv, Israel
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Cairo, MitchellNew York Med Coll, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, Valhalla, NY, USA
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Choi, Sung WonUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI, USA
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Dandoy, ChristopherCincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Bone Marrow Transplantat & Immune Deficiency, Cincinnati, OH, USA
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Delgado, DavidIndiana Univ Hosp, Dept Pediat, Indianapolis, IN, USA
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Gale, Robert PeterImperial Coll London, Dept Med, Div Expt Med, Hematol Res Ctr, London, England
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Hale, GregoryJohns Hopkins All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL, USA
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Frangoul, HaydarTriStar Centennial, Childrens Hosp, Pediat Hematol Oncol, Nashville, TN USA; Sarah Cannon Res Inst, Nashville, TN, USA
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Kamble, Rammurti T.Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX, USA
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Kharfan-Dabaja, MohamedH Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
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Lehman, LeslieDana Farber Canc Inst, Dept Pediat Hematol Oncol, Boston, MA, USA
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Levine, JohnIcahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY, USA
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MacMillan, MargaretUniv Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN, USA
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Marks, David I.Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England
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Nishihori, TaigaH Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
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Olsson, RichardKarolinska Institutet,Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden(Swepub:uu)riols677
(author)
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Hematti, PeimanUniv Wisconsin Hosp & Clin, Dept Med, Div Hematol Oncol Bone Marrow Transplantat, Madison, WI, USA
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Ringden, OlovKarolinska Institutet
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Saad, AymanUniv Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL, USA
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Satwani, PrakashColumbia Univ, Med Ctr, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, New York, NY, USA
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Savani, Bipin N.Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN, USA
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Schultz, Kirk R.Univ British Columbia, British Columbias Childrens Hosp, Dept Pediat Hematol Oncol & Bone Marrow Transplan, Vancouver, BC, Canada
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Seo, SachikoEast Hosp, Natl Canc Res Ctr, Kashiwa, Chiba, Japan
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Shenoy, ShaliniWashington Univ, Dept Pediat Hematol Oncol, St Louis, MO, USA
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Waller, Edmund K.Emory Univ, Winship Canc Inst, Dept Hematol & Med Oncol, Atlanta, GA, USA
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Yu, LolieLouisiana State Univ, Hlth Sci Ctr, Ctr Canc & Blood Disorders, Div Hematol Oncol, New Orleans, LA, USA
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Horowitz, Mary M.Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI, USA
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Horan, JohnEmory Univ, Sch Med, Aflac Canc & Blood Disorders Ctr, Atlanta, GA, USA
(author)
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Emory Univ, Sch Med, Aflac Canc & Blood Disorders Ctr, 2015 Uppergate Dr NE, Atlanta, GA, USAMed Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI, USA; Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI , USA
(creator_code:org_t)
Related titles
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In:Biology of blood and marrow transplantation: Elsevier BV24:3, s. 521-5281083-87911523-6536
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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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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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Uppsala University
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Karolinska Institutet