title: Favourable effect of the combination of acute and chronic graft-versus-host disease on the outcome of allogeneic peripheral blood stem cell transplantation for advanced haematological malignancies.
abstract: To assess the influence of graft-versus-host disease (GVHD) on the outcome of patients with advanced haematological malignancies (AHM) who received a primary, unmodified allogeneic peripheral blood progenitor cells transplant (allo-PBT) from a human leucocyte antigen (HLA) identical sibling donor, we analysed 136 patients with myeloid neoplasms (n = 70) or lymphoproliferative disorders (n = 66), transplanted at 19 Spanish institutions. Median age was 35 years (range 1-61). The cumulative incidence of relapse for all patients was 34% (95% CI, 26-42%), 41% (95% CI, 33-49) for patients without GVHD and 14% (95% CI, 3-25) (P = 0.001) for patients with acute and chronic GVHD. After a median follow-up of 11 months (range 2-49), 60 (44%) patients remained alive with an actuarial probability of overall survival and disease-free survival (DFS) at 30 months of 31% (95% CI, 21-41%) and 28% (95% CI, 17-39%) respectively. In patients surviving > 100 d, the low incidence of relapse in those with acute and chronic GVHD led to a DFS of 57% (95% CI, 38-76%) compared with a DFS of 34% (95% CI, 17-51%) in the remaining patients (P = 0.03). Our results indicate a reduced incidence of relapse for patients with AHM receiving an unmodified allo-PBT and developing acute and chronic GVHD, which results in an improved DFS.
authors.affiliation: Division of Clinical Haematology, Hospital de la Sant Creu i Sant Pau, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Brunet
authors.forename: A
authors.initials: A
authors.lastname: Urbano-Ispizua
authors.forename: E
authors.initials: E
authors.lastname: Ojeda
authors.forename: D
authors.initials: D
authors.lastname: Ruiz
authors.forename: J M
authors.initials: JM
authors.lastname: Moraleda
authors.forename: M A
authors.initials: MA
authors.lastname: Díaz
authors.forename: D
authors.initials: D
authors.lastname: Caballero
authors.forename: J
authors.initials: J
authors.lastname: Bargay
authors.forename: J
authors.initials: J
authors.lastname: de la Rubia
authors.forename: C
authors.initials: C
authors.lastname: Solano
authors.forename: J
authors.initials: J
authors.lastname: Zuazu
authors.forename: J L
authors.initials: JL
authors.lastname: Diez
authors.forename: J
authors.initials: J
authors.lastname: de la Serna
authors.forename: I
authors.initials: I
authors.lastname: Espigado
authors.forename: A
authors.initials: A
authors.lastname: Alegre
authors.forename: J P
authors.initials: JP
authors.lastname: Torres
authors.forename: M
authors.initials: M
authors.lastname: Jurado
authors.forename: M
authors.initials: M
authors.lastname: Fernández
authors.forename: P
authors.initials: P
authors.lastname: Vivancos
authors.forename: E
authors.initials: E
authors.lastname: Carreras
authors.forename: F
authors.initials: F
authors.lastname: Hernández
authors.forename: J
authors.initials: J
authors.lastname: Maldonado
authors.forename: J
authors.initials: J
authors.lastname: Sierra
authors.forename: C
authors.initials: C
authors.lastname: Rozman
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease; D019337:Hematologic Neoplasms / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D015996:Survival Rate; D014184:Transplantation, Homologous