Reduced intensity conditioning increases risk of severe cGVHD : identification of risk factors for cGVHD in a multicenter setting
Afram, Gabriel (Karolinska University Hospital and Karolinska Institutet (Suecia))
Simón, Jose Antonio Pérez (Instituto de Biomedicina de Sevilla)
Remberger, Mats (Karolinska University Hospital and Karolinska Institutet (Suecia))
Caballero Velazquez, Teresa (Instituto de Biomedicina de Sevilla)
Martino Bofarull, Rodrigo (Institut d'Investigació Biomèdica Sant Pau)
Piñana, Jose Luis (Hospital Clinico Universitario)
Ringden, Olle (Karolinska University Hospital and Karolinska Institutet (Suecia))
Esquirol, Albert (Institut d'Investigació Biomèdica Sant Pau)
Lopez-Corral, Lucia (Hospital Universitario de Salamanca-IBSAL)
Garcia Cadenas, Irene (Institut d'Investigació Biomèdica Sant Pau)
López-Godino, Oriana (Hospital Universitario de Salamanca-IBSAL)
Malouf Sierra, Jorge 1971- (Institut d'Investigació Biomèdica Sant Pau)
Caballero, Dolores (Hospital Universitario de Salamanca-IBSAL)
Ljungman, Per (Karolinska University Hospital and Karolinska Institutet (Suecia))
Vazquez, Lourdes (Hospital Clínico Universitario (Salamanca))
Hägglund, Hans (Uppsala University Hospital)
Universitat Autònoma de Barcelona

Date:	2018
Abstract:	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 effect 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 profile of patients.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	ATG ; Graft-versus-host disease (GVHD) ; Risk factor
Published in:	Medical Oncology, Vol. 35 Núm. 6 (january 2018) , p. 79, ISSN 1559-131X

DOI: 10.1007/s12032-018-1127-2
PMID: 29696461

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