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Post-Transplant Events

Risk-factor analysis for predicting progressive- or quiescent-type chronic graft-versus-host disease in a patient cohort with a history of acute graft-versus-host disease after allogeneic stem cell transplantation

Bone Marrow Transplantation volume 37, pages 699–708 (2006)Cite this article

Abstract

This study attempts to identify variables that can predict the development of progressive- or quiescent-type chronic GVHD (pq cGVHD) and transplant outcomes after the diagnosis of cGVHD in 99 patients who experienced acute GVHD (aGVHD) after allogeneic SCT. The prognostic significance of various clinical parameters at diagnosis of cGVHD was examined to determine the prognostic factors for GVHD-specific survival (GSS) in patients with pq cGVHD. Among 118 patients who experienced any degree of aGVHD, 99 were evaluated for cGVHD. The incidence of overall and extensive pq cGVHD at 2 years was estimated as 84.4 and 63.1%, respectively. A multivariate analysis showed that severe aGVHD (grade 3, 4) (P=0.022), primary treatment failure (P=0.009) and elevated alkaline phosphatase (P=0.001) were all significant independent factors predicting a higher overall incidence of pq cGVHD. The GSS and probability of systemic immunosuppressive treatment at 2 years after diagnosis of cGVHD were estimated as 55.9 and 51.9%. GVHD-specific survival was significantly associated with performance status (P=0.004) and lymphocytopenia (⩽1000/μl, P=0.022) at diagnosis of cGVHD by Cox's proportional hazard model. Severe aGVHD, primary treatment failure (PTF), lymphocytopenia and elevated alkaline phosphatase may be useful predictive factors for the development of pq cGVHD in patients who experience aGVHD after allogeneic SCT.

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Acknowledgements

SKS and DHK contributed equally and assume primary responsibility for this work. SKS and DHK were responsible for the study design, supervision of data collection, data analysis, writing the manuscript and critical revision of the manuscript. J-HB, J-GK and K-BL were involved to varying degrees in the interpretation of the data and critical revision of the manuscript. I-HS was responsible for the statistical analysis. K-HL, J-HL, S-JC and J-HL were involved in the data collection and critical revision of the manuscript.

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Authors and Affiliations

  1. Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea

    S K Sohn, D H Kim, J H Baek, J G Kim & K B Lee

  2. Department of Hematology, University of Ulsan, Asan Medical Center, Seoul, Korea

    K-H Lee, J-H Lee, S-J Choi & J-H Lee

  3. Department of Biostatistics, Taegu Catholic University, School of Medicine, Daegu, Korea

    I-H Shin

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  1. S K Sohn
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Correspondence to D H Kim.

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Sohn, S., Kim, D., Baek, J. et al. Risk-factor analysis for predicting progressive- or quiescent-type chronic graft-versus-host disease in a patient cohort with a history of acute graft-versus-host disease after allogeneic stem cell transplantation. Bone Marrow Transplant 37, 699–708 (2006). https://doi.org/10.1038/sj.bmt.1705313

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