Abstract

BACKGROUND: Acute graft-versus-host disease (aGVHD) remains the most common and challenging complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). An important obstacle to the therapeutic effect of aGVHD is the inability to identify risk factors for an individual patient at the onset of symptoms. We performed a retrospective study with the aim of defining clinically meaningful pre-transplantation risk factors for grades II-IV aGVHD patients.

MATERIAL AND METHODS: To identify pre-transplantation risk factors for grades II-IV aGVHD after allo-HSCT, we performed a retrospective study in 292 patients who underwent allo-HSCT at our center from January 2010 to July 2015.

RESULTS: The cumulative incidence of grades II–IV aGVHD was 36.6±2.8%. The most common target organ of aGVHD was the skin (46.7%), followed by the gastrointestinal tract (29.9%). The risk factors we identified included HLA-mismatched related donors (odds ratio [OR], 3.21; 95% confidence interval [CI], 1.82–5.67) and conditioning regimens containing TBI but no ATG (OR, 2.66; 95% CI, 1.40–5.06). Simultaneously, transplantation with an identical sibling donor (OR, 0.31; 95% CI, 0.18–0.55) and the use of ATG in the conditioning regimen containing TBI (OR 0.37; 95% CI, 0.15–0.93) were two factors found to be associated with a decreased risk of grades II–IV aGVHD.

CONCLUSIONS: Our study suggests that pre-transplantation characteristics of donor and recipient play an important role in identifying patients at high risk for grades II–IV aGVHD, which provide a direction for the prevention and treatment of aGVHD in the future.

Keywords: Graft vs Host Disease, Risk Factors, Transplantation, Homologous