eISSN 2329-0358


Get your full text copy in PDF

The Incidence and Risk Factors for Chronic Graft-Versus-Host-Disease

Jerzy Wojnar, Sebastian Giebel, Aleksandra Holowiecka-Goral, Malgorzata Krawczyk-Kulis, Miroslaw Markiewicz, Krzysztof Wozniczka

Ann Transplant 2006; 11(2): 14-20

ID: 496967

Objectives: Chronic graft-versus-host-disease (cGVHD) deteriorates survival and quality of life after allogeneic hematopoietic cell transplantation (alloHCT). We evaluated the incidence and risk factors for this complication based on a single-center experience. Methods: 255 consecutive patients, aged 29 (10-56) years, who survived without disease progression after alloHCT performed between 1992- 2003 were included in the analysis. The preparative regimen was myeloablative, donors were either related (n=177) or unrelated volunteers (URD-HCT) (n=78). Results: Cumulative incidence of the overall and extensive cGVHD equaled 48% and 22%, respectively. In a multivariate analysis the following factors were associated with increased risk of cGVHD: preceding grade II-IV acute GVHD, recipient age ≥40 years, URD-HCT, the diagnosis of chronic myeloid leukemia (CML) or myelodysplastic syndrome, and CD3 cell dose ≥ 50×106/kg. Similar factors, excluding recipient age contributed to increased risk of extensive cGVHD, however, the cut-point for CD3 cell dose was 100×106/kg and the use of steroids for acute GVHD prophylaxis was found an additional risk factor. In a CML subgroup the risk of cGVHD was increased for patients previously treated with interferon. Conclusions: Various recipient-, donor-, and procedure-related factors are related to the risk of cGVHD. Individualized treatment and modification of risk factors may contribute to improved outcome.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree