Impact of graft-versus-host disease on the clinical outcome of allogeneic hematopoietic stem cell transplantation for non-malignant diseases
- 12 February 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Journal of Hematology
- Vol. 111 (6), 869-876
- https://doi.org/10.1007/s12185-020-02839-4
Abstract
The impact of acute and chronic graft-versus-host disease (GVHD) on clinical outcomes was retrospectively analyzed in 960 patients with non-malignant diseases (NMD) who underwent a first allogeneic hematopoietic stem cell transplantation (HSCT). Grade III–IV acute GVHD (but not grade I–II) was significantly associated with a lower rate of overall survival (OS), and higher non-relapse mortality (NRM) than that seen in patients without acute GVHD. Extensive (but not limited) GVHD was significantly associated with a lower OS rate and higher NRM than that seen in patients without chronic GVHD. Any grade of acute (but not chronic) GVHD was significantly associated with a lower incidence of relapse and a lower proportion of patients requiring a second HSCT or donor lymphocyte infusion for graft failure or mixed chimerism, but its impact on OS was almost negligible. Acute GVHD was significantly associated with lower OS rates in all disease groups, whereas chronic GVHD was significantly associated with lower OS rates in the primary immunodeficiency and histiocytosis groups. In conclusion, acute and chronic GVHD, even if mild, was associated with reduced OS in patients receiving HSCT for NMD and effective strategies should, therefore, be implemented to minimize GVHD.Keywords
This publication has 34 references indexed in Scilit:
- Impact of graft-versus-host disease on relapse and survival after allogeneic stem cell transplantation for pediatric leukemiaBone Marrow Transplantation, 2018
- Impact of graft-versus-host disease on outcomes after unrelated cord blood transplantationLeukemia, 2016
- Comparison of second transplantation and donor lymphocyte infusion for donor mixed chimerism after allogeneic stem cell transplantation for nonmalignant diseasesPediatric Blood & Cancer, 2016
- Hematopoietic stem cell transplantation for inborn errors of metabolism: A report from the Research Committee on Transplantation for Inborn Errors of Metabolism of the Japanese Ministry of Health, Labour and Welfare and the Working Group of the Japan Society for Hematopoietic Cell TransplantationPediatric Transplantation, 2016
- Reduced-intensity conditioning for allogeneic stem cell transplant in primary immune deficienciesExpert Review of Clinical Immunology, 2012
- Reduced-intensity conditioning significantly improves survival of patients with hemophagocytic lymphohistiocytosis undergoing allogeneic hematopoietic cell transplantationBlood, 2010
- Hematopoietic Stem Cell Transplantation for Bone Marrow Failure Syndromes in ChildrenTransplantation and Cellular Therapy, 2009
- Reduced intensity haemopoietic stem-cell transplantation for treatment of non-malignant diseases in childrenThe Lancet, 2004
- Effect of graft-versus-host disease on the outcome of bone marrow transplantation from an HLA-identical sibling donor using GVHD prophylaxis with cyclosporin A and methotrexateLeukemia, 2004
- Graft-versus-leukemia reactions after bone marrow transplantationBlood, 1990