Artículo
Reduced intensity conditioning increases risk of severe cGVHD: identification of risk factors for cGVHD in a multicenter setting
Autor/es | Afram, Gabriel
Pérez Simón, José Antonio Remberger, Mats Caballero Velázquez, Teresa Martino, Rodrigo Piñana, Jose Luis Ringden, Olle Esquirol, Albert Lopez-Corral, Lucia Hägglund, Hans |
Departamento | Instituto de Biomedicina de Sevilla (IBIS) Universidad de Sevilla. Departamento de Medicina |
Fecha de publicación | 2018 |
Fecha de depósito | 2024-04-12 |
Publicado en |
|
Resumen | 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 ... 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 efect 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 profle of patients. |
Cita | Afram, G., Pérez Simón, J.A., Remberger, M., Caballero Velázquez, T., Martino, R., Piñana, J.L.,...,Hägglund, H. (2018). Reduced intensity conditioning increases risk of severe cGVHD: identification of risk factors for cGVHD in a multicenter setting. Medical Oncology, 35 (6), 79. https://doi.org/10.1007/s12032-018-1127-2. |
Ficheros | Tamaño | Formato | Ver | Descripción |
---|---|---|---|---|
Reduced...pdf | 1012.Kb | [PDF] | Ver/ | |