Chronic graft-versus-host disease after allogeneic bone marrow transplantation from an unrelated donor: Incidence, risk factors and association with relapse. A report from the Japan Marrow Donor Program

Shinichi Ozawa, Chiaki Nakaseko, Miki Nishimura, Atsuo Maruta, Ryuko Cho, Chikako Ohwada, Hisashi Sakamaki, Hiroshi Sao, Shin Ichiro Mori, Shinichiro Okamoto, Kouichi Miyamura, Shunichi Kato, Takakazu Kawase, Yasuo Morishima, Yoshihisa Kodera

研究成果: Article査読

50 被引用数 (Scopus)

抄録

Chronic graft-versus-host disease (GVHD) remains the major cause of late morbidity and mortality after allogeneic stem cell transplantation. We retrospectively analysed 2937 patients who underwent bone marrow transplantation from an unrelated donor (UR-BMT) facilitated by the Japan Marrow Donor Program (JMDP) and survived beyond day 100 after transplantation. The cumulative incidence of chronic GVHD (limited + extensive) or extensive chronic GVHD at 5 years post-transplant was 45·8% and 28·2%, respectively. On multivariate analysis, seven variables predicting chronic GVHD were identified: recipient age over 20 years, donor age over 30 years, primary diagnosis of chronic myeloid leukaemia, human leucocyte antigen (HLA)-A or -B mismatch, total body irradiation-containing regimen, platelet count not having reached 50 × 109/l by day 100, and prior acute GVHD. Among 2609 patients with haematological malignancy, overall survival was significantly higher in patients with limited chronic GVHD but lower in patients with extensive chronic GVHD compared with those without chronic GVHD. The cumulative incidence of relapse among patients with limited or extensive chronic GVHD was significantly lower than that among patients without chronic GVHD. Our results suggest that limited chronic GVHD provides a survival benefit to patients with haematological malignancies by reducing the risk of relapse without increasing the risk of death from chronic GVHD.

本文言語English
ページ(範囲)142-151
ページ数10
ジャーナルBritish Journal of Haematology
137
2
DOI
出版ステータスPublished - 2007 4月
外部発表はい

ASJC Scopus subject areas

  • 血液学

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