Risk factors for acute graft-versus-host disease after allogeneic blood stem cell transplantation

Donna Przepiorka, Terry L. Smith, Jody Folloder, Issa Khouri, Naoto T. Ueno, Rakesh Mehra, Martin Körbling, Yang O. Huh, Sergío Giralt, James Gajewski, Michele Donato, Karen Cleary, David Claxton, Ira Braunschweig, Koen Van Besien, Borje S. Andersson, Paolo Anderlini, Richard Champlin

Research output: Contribution to journalArticle

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Abstract

We evaluated demographic characteristics and graft composition as risk factors for acute graft-versus-host disease (GVHD) in 160 adult recipients of HLA-identical allogeneic blood stem cell transplants. The patients received a median nucleated cell dose of 7.9 x 108/kg and median C34+ cell dose of 5.6 x 106/kg. GVHD prophylaxis consisted of cyclosporine (CSA) and steroids, tacrolimus (FK506) and steroids, or FK506 and methotrexate. Grades 2 to 4 GVHD occurred in 31% (95% CI, 23% to 39%), and grades 3 to 4 GVHD in 14% (95% CI, 8% to 20%). In univariate analyses, GVHD prophylaxis with CSA and high CD34+ cell doses were significant risk factors for grades 2 to 4 GVHD, but diagnosis, age, use of total body irradiation, donor sex, female donor for male recipient, donor parity, donor alloimmunization, viral serology, nucleated cell dose, CD3+ cell dose, and CD56+ cell dose did not alter the incidence of GVHD significantly. With a CD34+ cell dose less than 8 x 106 CD34+ cells/kg, the risk of grades 2 to 4 GVHD was significantly higher for those who received CSA (39%, 95% CI, 21% to 47%) in comparison with those on FK506 (18%, 95% CI, 10% to 26%) (P = .03), but GVHD prophylaxis regimen had less impact with a higher CD34+ cell dose (overall grades 2 to 4 GVHD rate 52%, 95% CI, 37% to 67%). GVHD prophylaxis and CD34+ cell dose are independent risk factors for acute GVHD after allogeneic blood stem cell transplantation.

Original languageEnglish (US)
Pages (from-to)1465-1470
Number of pages6
JournalBlood
Volume94
Issue number4
StatePublished - Aug 15 1999
Externally publishedYes

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Transplantation (surgical)
Stem Cell Transplantation
Graft vs Host Disease
Stem cells
Grafts
Blood Cells
Blood
Tacrolimus
Tissue Donors
Steroids
Transplants
Whole-Body Irradiation
Serology
Parity
Methotrexate
Cyclosporine

ASJC Scopus subject areas

  • Hematology

Cite this

Przepiorka, D., Smith, T. L., Folloder, J., Khouri, I., Ueno, N. T., Mehra, R., ... Champlin, R. (1999). Risk factors for acute graft-versus-host disease after allogeneic blood stem cell transplantation. Blood, 94(4), 1465-1470.

Risk factors for acute graft-versus-host disease after allogeneic blood stem cell transplantation. / Przepiorka, Donna; Smith, Terry L.; Folloder, Jody; Khouri, Issa; Ueno, Naoto T.; Mehra, Rakesh; Körbling, Martin; Huh, Yang O.; Giralt, Sergío; Gajewski, James; Donato, Michele; Cleary, Karen; Claxton, David; Braunschweig, Ira; Van Besien, Koen; Andersson, Borje S.; Anderlini, Paolo; Champlin, Richard.

In: Blood, Vol. 94, No. 4, 15.08.1999, p. 1465-1470.

Research output: Contribution to journalArticle

Przepiorka, D, Smith, TL, Folloder, J, Khouri, I, Ueno, NT, Mehra, R, Körbling, M, Huh, YO, Giralt, S, Gajewski, J, Donato, M, Cleary, K, Claxton, D, Braunschweig, I, Van Besien, K, Andersson, BS, Anderlini, P & Champlin, R 1999, 'Risk factors for acute graft-versus-host disease after allogeneic blood stem cell transplantation', Blood, vol. 94, no. 4, pp. 1465-1470.
Przepiorka D, Smith TL, Folloder J, Khouri I, Ueno NT, Mehra R et al. Risk factors for acute graft-versus-host disease after allogeneic blood stem cell transplantation. Blood. 1999 Aug 15;94(4):1465-1470.
Przepiorka, Donna ; Smith, Terry L. ; Folloder, Jody ; Khouri, Issa ; Ueno, Naoto T. ; Mehra, Rakesh ; Körbling, Martin ; Huh, Yang O. ; Giralt, Sergío ; Gajewski, James ; Donato, Michele ; Cleary, Karen ; Claxton, David ; Braunschweig, Ira ; Van Besien, Koen ; Andersson, Borje S. ; Anderlini, Paolo ; Champlin, Richard. / Risk factors for acute graft-versus-host disease after allogeneic blood stem cell transplantation. In: Blood. 1999 ; Vol. 94, No. 4. pp. 1465-1470.
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abstract = "We evaluated demographic characteristics and graft composition as risk factors for acute graft-versus-host disease (GVHD) in 160 adult recipients of HLA-identical allogeneic blood stem cell transplants. The patients received a median nucleated cell dose of 7.9 x 108/kg and median C34+ cell dose of 5.6 x 106/kg. GVHD prophylaxis consisted of cyclosporine (CSA) and steroids, tacrolimus (FK506) and steroids, or FK506 and methotrexate. Grades 2 to 4 GVHD occurred in 31{\%} (95{\%} CI, 23{\%} to 39{\%}), and grades 3 to 4 GVHD in 14{\%} (95{\%} CI, 8{\%} to 20{\%}). In univariate analyses, GVHD prophylaxis with CSA and high CD34+ cell doses were significant risk factors for grades 2 to 4 GVHD, but diagnosis, age, use of total body irradiation, donor sex, female donor for male recipient, donor parity, donor alloimmunization, viral serology, nucleated cell dose, CD3+ cell dose, and CD56+ cell dose did not alter the incidence of GVHD significantly. With a CD34+ cell dose less than 8 x 106 CD34+ cells/kg, the risk of grades 2 to 4 GVHD was significantly higher for those who received CSA (39{\%}, 95{\%} CI, 21{\%} to 47{\%}) in comparison with those on FK506 (18{\%}, 95{\%} CI, 10{\%} to 26{\%}) (P = .03), but GVHD prophylaxis regimen had less impact with a higher CD34+ cell dose (overall grades 2 to 4 GVHD rate 52{\%}, 95{\%} CI, 37{\%} to 67{\%}). GVHD prophylaxis and CD34+ cell dose are independent risk factors for acute GVHD after allogeneic blood stem cell transplantation.",
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AU - Mehra, Rakesh

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