A European multicenter study of chronic graft-versus-host disease. The role of cytomegalovirus serology in recipients and donors--acute graft-versus-host disease, and splenectomy.
A group of 466 leukemic bone marrow transplanted patients were reported from 17 European bone marrow transplantation teams. Of these, 285 survived more than 3 months and could be evaluated for chronic GVHD. The cumulative incidence of chronic GVHD was 32% two years after BMT. The following factors were statistically significantly associated with chronic GVHD in bivariate analysis: high donor and recipient age, splenecacute GVHD, pretransplant seropositivity to CMV among the recipients and the donors, and donor seropositivity to 3 or 4 different herpesviruses, compared with 0-2, prior to BMT. In multivariate analysis pretransplant recipient CMV seropositivity in combination with donor CMV seropositivity prior to BMT (P = 0.0006), a previous grade II-IV acute GVHD (P = 0.001), and splenectomy (P = 0.01) were significantly associated with chronic GVHD. Thus, in addition to acute GVHD, CMV immune donor cells may be triggered by latent CMV in the recipient, which may play a role in the triggering of chronic GVHD. The possible role of splenectomy in GVHD is also discussed.
Boström
L
L
Leukaemia Working Party of the European Group for Bone Marrow Transplantation.
Ringdén
O
O
Jacobsen
N
N
Zwaan
F
F
Nilsson
B
B
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005060:Europe; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood / Q000382:microbiology* / Q000473:pathology; D006564:Herpesviridae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012307:Risk Factors; D012698:Serologic Tests; D013156:Splenectomy