Graft-versus-host disease in children: the AIEOP-BMT Group experience with cyclosporin A.
We retrospectively analyzed the data base of the Italian Association of Pediatric Hematology/Oncology BMT Group on the incidence and severity of GVHD in children given allogeneic BMT from HLA-identical sibling and receiving cyclosporin A (CsA) alone as GVHD prophylaxis. The study population included 145 patients for acute GVHD and 114 children at risk for chronic GVHD. Twelve patients had non-malignant diseases and 133 patients were affected by malignant disorders. Among the 145 patients (50 females, 95 males), 107 (74%) presented acute GVHD and 38 (26%) had no sign of disease. In the group of patients with acute GVHD, 38 children (26% of the whole study population) were found to have grade II disease, 9 (6% of the whole) grade III, 4 (3%) grade IV. Donor-recipient sex pairs had no significant influence on incidence of acute GVHD neither did donor-recipient age class stratification. Of the 114 patients evaluated for chronic GVHD, 86 (76%) developed no disease while 23 patients (20%) presented secondary chronic GVHD and 5 (4%) had de novo chronic GVHD. The incidence of chronic GVHD was higher in F-M than in M-M donor-recipient sex pairs (33% vs 11%, p < 0.05), with no difference between F-F and M-F. In patients of > 10 years, a higher incidence of chronic GVHD was observed in both female donors and recipients compared with male donors and recipients (48% vs 20% and 47% vs 19%, respectively, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Locatelli
F
F
Italian Association of Pediatric Hematology/Oncology, BMT Group, Department of Pediatrics, University of Pavia.
Uderzo
C
C
Dini
G
G
Zecca
M
M
Arcese
W
W
Messina
C
C
Andolina
M
M
Miniero
R
R
Porta
F
F
Rovelli
A
A
D000208:Acute Disease; D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002908:Chronic Disease; D016572:Cyclosporine / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007938:Leukemia / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D008297:Male; D012042:Registries; D012307:Risk Factors; D012727:Sex Characteristics; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous
D016572:Cyclosporine