Impact of conditioning intensity and TBI on acute GVHD after hematopoietic cell transplantation

H. Nakasone, T. Fukuda, J. Kanda, T. Mori, S. Yano, T. Kobayashi, K. Miyamura, T. Eto, H. Kanamori, K. Iwato, N. Uchida, S. Mori, T. Nagamura-Inoue, T. Ichinohe, Y. Atsuta, T. Teshima, M. Murata

研究成果: Article査読

36 被引用数 (Scopus)

抄録

The impact of the conditioning intensity and TBI on acute GVHD (aGVHD) is still a matter of debate. We analyzed 6848 adult recipients who received allogeneic hematopoietic cell transplants (HCT) between 2006 and 2011 in Japan. The subjects were divided into groups who had received myeloablative conditioning (MAC) or reduced-intensity conditioning (RIC), either with or without TBI. There was a significant difference in the incidence of aGVHD 2-4 among the different conditioning types: 39% in TBI-MAC, 35% in TBI-RIC and 32% in both no-TBI MAC and no-TBI-RIC (P<0.001). In a multivariate analysis, TBI-MAC, but not no-TBI MAC, was significantly associated with an increased risk of aGVHD 2-4 (hazard ratio (HR) 1.33, P<0.01), whereas TBI-RIC was associated with an increased risk of GVHD 3-4 (HR 1.36, P=0.048). TBI-MAC and TBI-RIC were significantly associated with skin and gastrointestinal aGVHD. Subgroup analyses demonstrated that not only TBI-MAC, but also TBI-RIC, was significantly associated with aGVHD 2-4 in older patients. Furthermore, high-dose TBI only had an adverse impact on aGVHD 2-4 in HLA-matched HCT. Impacts of intensity and TBI on aGVHD differ by patient backgrounds, and this difference should be considered to establish a risk-adapted strategy for the prevention of aGVHD.

本文言語English
ページ(範囲)559-565
ページ数7
ジャーナルBone Marrow Transplantation
50
4
DOI
出版ステータスPublished - 2015 4月 4
外部発表はい

ASJC Scopus subject areas

  • 血液学
  • 移植

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