Annals of Hematology

, Volume 93, Issue 5, pp 855–861

Serum albumin level predicts survival of patients with gastrointestinal acute graft-versus-host disease after allogeneic stem cell transplantation

  • Francis Ayuk
  • Lara Bussmann
  • Tatjana Zabelina
  • Ronja Veit
  • Haefaa Alchalby
  • Christine Wolschke
  • Heinrich Lellek
  • Ulrike Bacher
  • Axel R. Zander
  • Nicolaus Kröger
Original Article

DOI: 10.1007/s00277-013-1957-0

Cite this article as:
Ayuk, F., Bussmann, L., Zabelina, T. et al. Ann Hematol (2014) 93: 855. doi:10.1007/s00277-013-1957-0

Abstract

In a retrospective single-centre study, we analysed the prognostic impact of factors identifiable at initial diagnosis of acute GVHD (aGVHD). We retrospectively analysed 495 adult patients of whom 308 (62 %) developed acute GVHD (I–IV) and were included in further analysis. Gut aGVHD was diagnosed in 163/308 cases (53 %). Conditioning was myeloablative conditioning (MAC) in 123 (39.9 %) and reduced intensity (RIC) in 185 (60.1 %) patients. Median serum albumin level at diagnosis of aGVHD was 34 g/l, which was used as cut-off for low vs. normal albumin levels. In patients with gut aGVHD, low albumin level at the time of diagnosis of aGVHD was associated with poorer overall survival (OS) which was 52 vs. 67 % at 1 year and 40 vs. 61 % at 3 years, p = 0.015. In patients with only skin aGVHD, 1- and 3-year OS of patients with low vs. normal albumin levels were 72 vs. 72 % and 59 vs. 57 %, respectively, p = 0.69. In multivariate analysis of patients with gut aGVHD, low serum albumin level ≤34 g/l (relative risk (RR) 2.13, p = 0.003), gut aGVHD grades 3–4 (RR 2.70, p = 0.001), RIC (RR 1.84, p = 0.024), matched unrelated donor (RR 1.86, p = 0.18) and mismatched unrelated donor (RR 2.76, p = 0.03) retained negative impact on OS. Subgroup analysis revealed that impact of albumin was restricted to patients with gut aGVHD after RIC. Low serum albumin levels are associated with poorer OS in patients with gut but not skin aGVHD after RIC but not MAC allogeneic stem cell transplantation.

Keywords

Serum albuminGut acute GVHD

Supplementary material

277_2013_1957_MOESM1_ESM.doc (37 kb)
ESM 1(DOC 37 kb)

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Francis Ayuk
    • 1
  • Lara Bussmann
    • 1
  • Tatjana Zabelina
    • 1
  • Ronja Veit
    • 1
  • Haefaa Alchalby
    • 1
  • Christine Wolschke
    • 1
  • Heinrich Lellek
    • 1
  • Ulrike Bacher
    • 1
  • Axel R. Zander
    • 1
  • Nicolaus Kröger
    • 1
  1. 1.Clinic for stem cell transplantationUniversity Medical Center Hamburg-EppendorfHamburgGermany