Titre du document / Document title

Risk factors for chronic graft-versus-host disease after bone marrow transplantation: a retrospective single centre analysis

Auteur(s) / Author(s)

CARLENS S. ^{(1 2)} ; RINGDEN O. ^{(1 2)} ; REMBERGER M. ⁽¹⁾ ; LÖNNQVIST B. ⁽³⁾ ; HÄGGLUND H. ⁽²⁾ ; KLAESSON S. ⁽⁴⁾ ; MATTSSON J. ⁽²⁾ ; SVAHN B.-M. ⁽²⁾ ; WINIARSKI J. ⁽⁴⁾ ; LJUNGMAN P. ⁽³⁾ ; ASCHAN J. ⁽³⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Clinical Immunology, Huddinge Hospital, Huddinge, SUEDE
⁽²⁾ Department of Transplantation Surgery, Huddinge Hospital, Huddinge, SUEDE
⁽³⁾ Department of Haematology, Huddinge Hospital, Huddinge, SUEDE
⁽⁴⁾ Department of Paediatrics, Huddinge Hospital, Huddinge, SUEDE

Résumé / Abstract

Among 551 consecutive recipients of allogeneic bone marrow transplants, 451 survived more than 3 months and were evaluated for chronic graft-versus-host disease (GVHD). Most of the donors were HLA-identical siblings or parents (n = 334). Patients with HLA-mismatched donors (n = 30) and matched unrelated donors (MUD) (n = 87) were also included in the study. In the analysis of all patients, the 5-year cumulative incidence of chronic GVHD was 45%. We analysed 34 risk factors. High recipient age was the single most important risk factor (P < 0.001). Other significant risk factors in multivariate analysis were: acute GVHD grades I-IV (P < 0.001), immune female donor to male recipient (P = 0.006) and chronic myelogenous leukaemia (CML), compared with all other diagnoses (P = 0.014). The cumulative 5-year incidence of chronic GVHD, with no significant risk factors present, was 9%, 29% with one risk factor, 53% with two, 68% with three and 75% with all four risk factors present. In patients with HLA-identical sibling donors and GVHD prophylaxis consisting of a combination of methotrexate (MTX) and cyclosporin A (CsA) (n = 208), increasing recipient age (P < 0.001) and CML (P = 0.007), were found to be significant risk factors for chronic GVHD. Finally, a multivariate analysis in recipients of bone marrow from unrelated donors (n = 89) showed recipient age alone (P = 0.006) to be significantly associated with chronic GVHD.

Revue / Journal Title

Bone marrow transplantation   ISSN 0268-3369   CODEN BMTRE9 

Source / Source

1998, vol. 22, n^o8, pp. 755-761 (46 ref.)

Langue / Language

Anglais

Editeur / Publisher

Nature Publishing Group , Basingstoke, ROYAUME-UNI  (1986) (Revue)

Mots-clés anglais / English Keywords

Homograft ; Graft ; Bone marrow ; Graft versus host reaction ; Chronic ; Complication ; Risk factor ; Retrospective ; Human ; Immunopathology ;

Mots-clés français / French Keywords

Homogreffe ; Greffe ; Moelle osseuse ; Maladie greffon hôte ; Chronique ; Complication ; Facteur risque ; Rétrospective ; Homme ; Immunopathologie ;

Mots-clés espagnols / Spanish Keywords

Homoinjerto ; Injerto ; Médula ósea ; Enfermedad injerto huesped ; Crónico ; Complicación ; Factor riesgo ; Retrospectiva ; Hombre ; Inmunopatología ;

Localisation / Location

INIST-CNRS, Cote INIST : 21176, 35400007149298.0040