Incidence, Risk Factors, and Long-Term Outcomes of Sclerotic Graft-versus-Host Disease after Allogeneic Hematopoietic Cell Transplantation
- Authors
- Uhm, Ji eun; Hamad, Nada; Shin, Elizabeth M.; Michelis, Fotios; Shanavas, Mohamed; Gupta, Vikas; Kuruvilla, John; Lipton, Jeffrey H.; Messner, Hans A.; Seftel, Matthew; Kim, Dong Hwan
- Issue Date
- Jul-2014
- Publisher
- ELSEVIER SCIENCE INC
- Keywords
- Chronic graft-versus-host; disease; Sclerosis; Allogeneic hematopoietic stem; cell transplantation
- Citation
- BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, v.20, no.11, pp.1751 - 1757
- Indexed
- SCIE
SCOPUS
- Journal Title
- BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
- Volume
- 20
- Number
- 11
- Start Page
- 1751
- End Page
- 1757
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/159514
- DOI
- 10.1016/j.bbmt.2014.07.001
- ISSN
- 1083-8791
- Abstract
- Sclerotic chronic graft-versus-host disease (sclGVHD) is associated with significant morbidity and a poor quality of life. We reviewed 502 patients diagnosed with chronic GVHD and analyzed the incidence and risk factors of sclGVHD and long-term outcomes and immunosuppressive therapy (IST) cessation in patients with sclGVHD. With a median onset at 18 months the cumulative incidence of sclGVHD was estimated at 22.6% at 5 years (95% confidence interval, 18.6% to 26.8%). Univariate and multivariate analysis identified 2 risk factors for sclGVHD: non-T cell depletion (hazard ratio [HR] 9.09, P ˂ .001) and peripheral blood stem cell (HR 3.87, P ˂ .001). Overall survival (OS) at 5 years was significantly better in the scIGVHD group (88.1%) compared with the non-sclGVHD group (62.7%; P ˂ .001), as were nonrelapse mortality (7.3% versus 21.5% at 5 years) and relapse rates (9.1% versus 19.3% at 5 years). There was no difference in the rate of IST cessation at 5 years (44.8% versus 49.9%, P = .312), but there was a trend of longer IST duration in the sclGVHD group compared with the non-sclGVHD group (median 71.6 months versus 62.9 months). In conclusion, T cell depletion and graft source affect the risk of sclGVHD. SclGVHD did not adversely affect long-term outcomes or IST duration.
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