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Graft-Versus-Host Disease

Prophylaxis and treatment of GVHD after allogeneic haematopoietic SCT: a survey of centre strategies by the European Group for Blood and Marrow Transplantation

Bone Marrow Transplantation volume 47, pages 1459–1464 (2012)Cite this article

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Abstract

Recommendations on indications for allogeneic haematopoietic SCT have been presented, but transplantation techniques remain poorly standardized. Pre-transplant risk factors are well defined, and reported outcomes vary markedly among patients with similar risk characteristics. It would be of importance to know the impact of differences in treatment procedures. To study properly the different components of allogeneic transplantation, standardization of at least some central procedures would be needed. As the first step, the European Group for Blood and Marrow Transplantation (EBMT) performed a survey among all its 372 member centres performing allogeneic transplantations about their strategies in preventing and treating GVHD. Responses from 79 centres (21% return) from 25 countries (60% return) were received. Although some trends toward more uniform policies compared with a survey carried out 15 years earlier were observed, the present survey still showed marked variability in the GVHD prophylaxis and treatment strategies. On the basis of these findings, EBMT is developing a consensus process aiming at a standardized strategy.

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References

  1. Gratwohl A, Stern M, Brand R, Apperley J, Baldomero H, de Witte T et al. Risk score for outcome after allogeneic hematopoietic stem cell transplantation: a retrospective analysis. Cancer 2009; 116: 4715–4726.

    Article  Google Scholar 

  2. Ruutu T, Niederwieser D, Gratwohl A, Apperley JF . A survey of the prophylaxis and treatment of acute GVHD in Europe: a report of the European Group for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 1997; 19: 759–764.

    Article  CAS  PubMed  Google Scholar 

  3. Bacigalupo A, van Lint MT, Occhini D, Gualandi F, Lamperelli T, Sogno G et al. Increased risk of leukemia relapse with high-dose cyclosporine A after allogeneic marrow transplantation for acute leukemia. Blood 1991; 77: 1423–1428.

    CAS  PubMed  Google Scholar 

  4. Locatelli F, Zecca M, Rondelli R, Bonetti F, Dini G, Prete A et al. Graft versus host disease prophylaxis with low dose cyclosporine reduces the risk of relapse in children with acute leukemia given HLA identical sibling bone marrow transplantation: results of a randomized trial. Blood 2000; 95: 1572–1579.

    CAS  PubMed  Google Scholar 

  5. Bacigalupo A . Management of acute graft-versus-host disease. Br J Haematol 2007; 137: 87–98.

    Article  CAS  PubMed  Google Scholar 

  6. Ferrara JLM, Levine JE, Reddy P, Holler E . Graft-versus-host disease. Lancet 2009; 373: 1550–1561.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Inamoto Y, Flowers MED, Lee SJ, Carpenter PA, Warren EH, Deeg J et al. Influence of immunosuppressive treatment on risk of recurrent malignancy after allogeneic hematopoietic cell transplantation. Blood 2011; 118: 456–463.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Ljungman P, Bregni M, Brune M, Cornelissen J, de Witte T, Dini G et al. Allogeneic and autologous transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe 2009. Bone Marrow Transplant 2010; 45: 219–234.

    Article  CAS  PubMed  Google Scholar 

  9. Goldman J . Special report: bone marrow transplants using volunteer donors, recommendations and requirements for a standardized practice throughout the world—1994 update. Blood 1994; 84: 2833–2839.

    CAS  PubMed  Google Scholar 

  10. World Marrow Donor Association International standards for unrelated hematopoietic stem cell donor registries. www.worldmarrow.org,_Standards_December_2007.pdf.

  11. Clift RA, Buckner CD, Appelbaum FA, Bearman SI, Petersen FE, Fisher LD et al. Allogeneic marrow transplantation in patients with acute myeloid leukemia in first remission: A randomized trial of two irradiation regimens. Blood 1990; 76: 1867–1871.

    CAS  PubMed  Google Scholar 

  12. Pavlů J, Szydlo RM, Goldman JM, Apperley JF . Three decades of transplantation for chronic myeloid leukemia: what have we learned? Blood 2011; 117: 755–763.

    Article  PubMed  Google Scholar 

  13. Frassoni F, Labopin M, Powles R, Mary J-Y, Arcese W, Bacigalupo A et al. Effect of centre on outcome of bone-marrow transplantation for acute myeloid leukaemia. Lancet 2000; 355: 1393–1398.

    Article  CAS  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Medicine, Division of Haematology, Helsinki University Central Hospital, Helsinki, Finland

    T Ruutu

  2. Department of Medical Statistics and Bioinformatica, Data Office EBMT Chronic Leukaemia Working Party, Leiden University Medical Centre, Leiden, The Netherlands

    A van Biezen & A Henseler

  3. Klinik für Innere Medizin, Klinikum Bremen—Mitte, Bremen, Germany

    B Hertenstein

  4. Service d'Hematologie, Hôpital Saint Antoine, Paris, France

    L Garderet

  5. Service d'Hematologie, Departement Medecine Interne, Hopitaux Universitaires de Geneve, Geneva, Switzerland

    J Passweg

  6. Centre Hospitalier et Universitaire (CHU) de Nantes, Hématologie Clinique, INSERM CRCNA, UMR 892, Université de Nantes, Faculté de Médecine, Nantes, France

    M Mohty

  7. Centre d'Investigation Clinique en Cancérologie (CI2C), CHU de Nantes, Nantes, France

    M Mohty

  8. Department of Haematology, Addenbrookes Hospital, Cambridge, UK

    A Sureda

  9. Division of Hematology, Oncology and Hemostasiology, University Hospital Leipzig, Leipzig, Germany

    D Niederwieser

  10. Center for Stem Cell Transplantation, University Hospital Basel, Basel, Switzerland

    A Gratwohl

  11. Department of Tumor Immunology, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    T de Witte

Authors
  1. T Ruutu
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  2. A van Biezen
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  3. B Hertenstein
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  4. A Henseler
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  5. L Garderet
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  6. J Passweg
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  7. M Mohty
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  8. A Sureda
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  9. D Niederwieser
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  10. A Gratwohl
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  11. T de Witte
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Corresponding author

Correspondence to T Ruutu.

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The authors declare no conflict of interest.

Appendix

Appendix

Participating centres

Austria

Medical University Graz, Department of Internal Medicine, Division of Hematology

Medizinische Universität Wien, Klinik für Innere Medizin, Knochenmarktransplantation

Belgium

Antwerp University Hospital (UZA), Department of Hematology, Antwerp Edegem

Cliniques Universitaires St Luc, Department of Haematology, Brussels

University Hospital VUB, Department of Medical Oncology/Hematology, Brussels

University Hospital Gasthuisberg, Department of Hematology, Leuven

University of Liege, Department of Hematology

Brasil

Universidade Estadual de Campinas/TMO/UNICAMP, Cidade Universitaria ‘Zeferino Vaz’, Campinas

Croatia

University Hospital Center Rebro, Zagreb

Czech Republic

Charles University Hospital, Department of Hematology/Oncology, Pilsen

Institute of Hematology and Blood Transfusion, Prague

Denmark

Rigshospitalet, BMT Unit, Department of Hematology, Copenhagen

Estonia

Tartu University Hospital, Clinic of Hematology and Oncology

Finland

Helsinki University Central Hospital, Department of Medicine, Division of Haematology

France

CHRU, Service des Maladies du Sang, Angers

Hopital E. Herriot, BMT Unit, Lyon

Hopital Saint Antoine, Department of Hematology, Paris

Hopital Bretonneau, Service d'Oncologie Médical, Tours

Germany

Charité Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m.S. Hämatologie/Onkologie

University Hospital Erlangen, Department of Medicine 5

University of Freiburg, Department of Medicine-Hematology, Oncology

Ernst-Moritz-Arndt-Universität Greifswald, Medizinische Universitätsklinik C

Martin-Luther-Universität Halle-Wittenberg, BMT Section, State Center for Cell and Gene Therapy, Department of Internal Medicine IV, Halle

University Hospital Eppendorf, Bone Marrow Transplantation Centre, Hamburg

Hannover Medical University, Department of Hematology/Oncology

University of Heidelberg, Medizinische Klinik und Poliklinik V

Friedrich-Schiller-Universität Jena, Klinik für Innere Medizin II

Klinikum Karlsruhe gGmbH, II Medizinische Klinik, Hämatologie, Onkologie

Universität Rostock, Klinik für Innere Medizin/Hämatologie/Onkologie

Deutsche Klinik für Diagnostik, KMT Zentrum, Wiesbaden

Greece

George Papanicolaou General Hospital, Haematology Department/BMT Unit, Thessaloniki

Ireland

St James Hospital Trinity College, Department of Hematology, Dublin

Israel

Beilinson Hospital, Hematology and BMT Department, Petach-Tikva

Chaim Sheba Medical Center, Tel-Hashomer

Italy

Azienda Ospedali Riuniti di Ancona, Clinica di Ematologia, Ancona-Torrete

Bologna University, S.Orsola-Malpighi Hospital, Institute of Hematology and Medical Oncology L and A Seràgnoli

Ospedale Ferrarotto, Divisione Clinicizzata di Ematologia, Catania

Ospedale di Careggi, BMT Unit, Department of Hematology, Firenze

Ospedale San Gerardo, Clinica Ematologica dell'Universita Milano-Biocca, Monza

Humanitas Cancer Center, Transplantation Unit, Department of Oncology-Hematology, Milano

Azienda Ospedaliera, Centro Unico Regionale Trapianti, Reggio Calabria

Universita Cattolica S Cuore, Istituto di Ematologia, Rome

Lebanon

American University of Beirut, Department of Internal Medicine

The Netherlands

University Medical Center Groningen, Department of Hematology

University Hospital Maastricht, Department of Internal Medicine, Hematology/Oncology

University Medical Centre, Department of Haematology, Utrecht

New Zealand

Canterbury Health Laboratories, Department of Haematology, Christchurch

Wellington Regional Bone Marrow Transplant Unit, Wellington Hospital

Norway

Haukeland University Hospital, Department of Haematology, Bergen

Rikshospitalet, Department of Medicine, Oslo

Poland

University Hospital, Collegium Medicum UMK, Pediatric Hematology and Oncology, Bydgoszcz

Lower Silesian Centre for Cellular Transplantation with National Bone Marrow Donor Registry, Wroclaw

Slovenia

University Medical Center, Department of Hematology, Ljubljana

Spain

Hospital Universitari Germans Trias i Pujol, Barcelona

Hospital Vall d'Hebron, Unidad de Adultos, Barcelona

University Hospital of Asturias, Clinical Hematology Department, Oviedo

Hospital de Navarra, Servicio de Hematologia, Pamplona

Hospital U Marqués de Valdecilla, Servicio de Hematologia-Hemoterapia, Santander

Sweden

University Hospital, Department of Hematology, Linköping

University Hospital, Department of Hematology, Lund

Karolinska University Hospital, Centre for Allogeneic Stem Cell Transplantation Huddinge, Stockholm

Umeå University Hospital, Hematology

University Hospital, Department of Medicine, Uppsala

Switzerland

University Hospital, Hematology, Basel

Hopitaux Universitaires de Geneve, Departement Medecine Interne, Geneva

University Hospital, Clinic of Hematology, Zürich

Turkey

Akdeniz University Medical School, Department of Pediatric Hematology, Antalya

Medical Park Hospitals, Stem Cell Transplant Unit, Antalya

Ankara University Faculty of Medicine, Department of Hematology, Adult Stem Cell Transplantation Unit

Gazi Universitesi Tip Fakültesi Hastanesi, Eriskin Hematoloji Bilim Dali, Ankara

United Kingdom

Belfast City Hospital, Department of Haematology

University of Wales, College of Medicine, Department of Haematology, Cardiff

Bone Marrow Transplant Unit, Beatson, West of Scotland Cancer Centre, Glasgow

Leicester Royal Infirmary, Department of Haematology

Royal Liverpool University Hospital, Department of Haematology

Guy's Hospital, Department of Haematology, London

Imperial College, Department of Haematology, Hammersmith Hospital, London

Christie NHS Trust Hospital, Adult Leukaemia and Bone Marrow Transplant Unit, Manchester

Nottingham City Hospital

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Ruutu, T., van Biezen, A., Hertenstein, B. et al. Prophylaxis and treatment of GVHD after allogeneic haematopoietic SCT: a survey of centre strategies by the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 47, 1459–1464 (2012). https://doi.org/10.1038/bmt.2012.45

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