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Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical hematopoietic stem cell transplantation in acute myeloid leukemia.

Abstract
Chronic graft-versus-host disease (cGVHD) is a major complication following unmanipulated haploidentical hematopoietic stem cell transplantation (haplo-HSCT). We aimed to identify the risk factors for cGVHD in patients who underwent anti-thymocyte globulin-based haplo-HSCT for acute myeloid leukemia (n = 280). The diagnosis of cGVHD was in accordance with the National Institutes of Health consensus criteria. A total of 169 patients suffered from cGVHD. The patients who had 3 loci mismatched had a higher 8-year incidence of cGVHD (total, 66.0% vs. 53.7%, P = 0.031; moderate to severe, 42.4% vs. 30.1%, P = 0.036) than the patients who had 1 to 2 loci mismatched. The patients who had maternal donors had a higher 8-year incidence of moderate to severe cGVHD (49.2% vs. 32.9%, P = 0.024) compared with the patients who had other donors. The patients who had grades III to IV acute GVHD (aGVHD) had higher 8-year incidence of cGVHD (total, 88.0% vs. 50.4%, P < 0.001; moderate to severe, 68.0% vs. 27.0%, P < 0.001) compared with the patients without aGVHD. In multivariate analysis, grades III to IV aGVHD was the only independent risk factor for cGVHD. Thus, further interventions should be considered in patients with severe aGVHD to prevent cGVHD.
AuthorsMeng Lv, Xiaohui Zhang, Lanping Xu, Yu Wang, Chenhua Yan, Huan Chen, Yuhong Chen, Wei Han, Fengrong Wang, Jingzhi Wang, Kaiyan Liu, Xiaojun Huang, Xiaodong Mo
JournalFrontiers of medicine (Front Med) Vol. 13 Issue 6 Pg. 667-679 (Dec 2019) ISSN: 2095-0225 [Electronic] China
PMID31512033 (Publication Type: Journal Article)
Chemical References
  • Antilymphocyte Serum
Topics
  • Adolescent
  • Adult
  • Antilymphocyte Serum (therapeutic use)
  • Child
  • Child, Preschool
  • China
  • Female
  • Graft vs Host Disease (epidemiology, etiology)
  • Hematopoietic Stem Cell Transplantation (adverse effects)
  • Humans
  • Leukemia, Myeloid, Acute (mortality, surgery)
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Risk Factors
  • Survival Analysis
  • Transplantation Conditioning
  • Transplantation, Homologous (adverse effects)
  • Young Adult

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