Predictive Factors for Chronic Graft-versus-Host Disease and Leukemic Relapse After Allogeneic Bone Marrow Transplantation
Part of the
Experimental Hematology Today—1987
book series (HEMATOLOGY, volume 1987)
A retrospective multicenter study was carried out in 190 patients who were treated with cyclophosphamide, total body irradiation and allogeneic bone marrow transplantation due to ALL (N=86), AML (N=72), malignant lymphoma (N=6), myelofibrosis (N=2) or CML (N=24). Chronic GvHD occurred in 44 patients. Using Cox multivariate regression analysis with time dependent covariates, donor age >20 years, female donor >20 years to male recipient and preceding acute GvHD were found to predispose for chronic GvHD. When donor age was excluded from the model, cytomegalovirus (CMV) seropositive bone marrow donor was found to be a risk factor for chronic GvHD. However, the donor age effect on chronic GvHD could only in part be explained by an increased ratio of CMV seropositive donors with age.
Posttransplant relapse risk factors were analysed using multivariate analysis in 163 patients with acute leukaemia or malignant lymphoma. Relapse occurred in 36 cases. Disease stage further advanced than 1.remission, transplantation during relapse and donor age >20 years were found to increase the risk of relapse, whereas a protective effect was observed when donor was CMV-seropositive or when using female donor to male recipient.
This study calls for further analyses of donor factors that may determine the risk of complications and relapse after allogeneic bone marrow transplantation.
KeywordsBone Marrow Transplantation Acute Leukaemia Acute GvHD Chronic GvHD Allogeneic Bone Marrow Transplantation
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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