Chronic Graft Versus Host Disease in Acute Leukemia Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplant: Analysis of Risk Factors, Pattern and Long Term Outcome
- 131 Downloads
Chronic graft versus host disease (cGVHD) is a common late complication of allogenic hematopoietic stem cell transplant (HSCT). We analyzed risk factors, pattern and long term transplant outcomes of cGVHD at a tertiary cancer centre. Seventy-seven consecutive patients who underwent HSCT for acute leukemia were included. Forty (52 %) patients developed cGVHD; 24 (60 %) extensive stage while 16 (40 %) limited stage. Oral cavity was the commonest site of involvement (25 patients) followed by liver, skin and lung. We found that female donor to male recipient transplant and diagnosis of acute lymphoblastic leukemia (ALL) were the only factors associated with increased risk of cGVHD. The incidence of leukemia relapse was 18 % in patients who developed cGVHD compared to 51 % in those who did not (P = 0.002). Four year overall survival and relapse free survival (RFS) were 62 and 46 % in patients who developed cGVHD compared to 29 % (P < 0.001) and 29 % (P < 0.001) in patients who did not develop cGVHD, respectively. We conclude that cGVHD is more common in male patients with female donors and in patients transplanted for ALL. Oral cavity is the commonest site of cGVHD in our patients and transplant related survival outcomes are superior in patients who develop cGVHD.
KeywordsAcute leukemia Chronic graft-versus-host disease Allogeneic stem cell transplantation Outcome Risk factors
Conflict of interest
The authors declare no conflict of interest.
- 6.Veltri L, Regier M, Cumpston A, Leadmon S, Tse W, Craig M, Hamadani M (2013) Incidence and pattern of graft-versus-host disease in patients undergoing allogenic transplantation after non myeloablative conditioning with total lymphoid irradiation and anti thymocyte globulin. Bone Marrow Res. doi: 10.1155/2013/414959 PubMedCentralPubMedGoogle Scholar
- 7.Gota V, Pathak K, Mittal S et al (2014) A limited sampling strategy for therapeutic drug monitoring of mycophenolate mofetil for prophylaxis of acute graft versus host disease in allogeneic stem cell transplantation. Bone Marrow Transpl 49:S295Google Scholar
- 9.Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ et al (2005) National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transpl 11:945–956CrossRefGoogle Scholar
- 13.Solano C, Martinez C, Brunet S, Tomás JF, Urbano-Ispizua A, Zuazu J et al (1998) Chronic graft versus host disease after allogenic peripheral blood progenitor cell or bone marrow transplantation from matched related donors. A case–control study. Bone Marrow Transpl 22:1129–1135CrossRefGoogle Scholar
- 14.Lee SJ, Klein JP, Barrett AJ, Ringden O, Antin JH, Cahn JY et al (2002) Severity of chronic graft-versus-host disease: association with treatment related mortality and relapse. Blood 100:406414Google Scholar