Survival and graft versus host disease in first 100 patients undergoing allogeneic peripheral blood stem cell transplantation: a single centre experience.
OBJECTIVE
To present the survival and evaluate the demographic characteristics as risk factors for acute and chronic graft versus host disease (GvHD) in 100 recipients of HLA identical related allogeneic peripheral blood stem cell transplantation.


METHODS
Indications for transplant were non-malignant and malignant haematological disorders. Bu/Cy conditioning was given for haematological malignancies and beta-Thalassaemia major, Cyclophosphamide was given in aplastic anaemia. GvHD prophylaxis was Cyclosporin and Methotrexate. The patients received a median nucleated cell dose of 7.93 10(8)/kg.


RESULTS
Of 100 recipients, 72 were males and 28 females. Median age was 13.5 years (range 1.5-44). There were 65 male and 35 female donors. Median age was 15 years (range 4-45). Grade-I aGvHD was noted in 18 (18%), Grades-II in 6 (6%), Grade-III in 3 (3%) while Grade-IV in 1 (1%) patients. Diagnosis was found to be a significant risk factor for aGvHD. Kaplan Meyer analysis showed that malignancy, aGvHD, recipients above 14 years of age, female patients and engraftment after 12 days were associated with poor outcome. Of 78 patients alive beyond 100 days, 19 (24%) developed cGvHD. Mean follow up was 466 days (range 30-1766). Median survival of this cohort of patients was 338 days (mean 479 days, 95% CI 72 - 729).


CONCLUSIONS
Incidence of acute and chronic GvHD was similar to published data. Grade of aGvHD, extent of cGvHD, female patients and haematological malignancies were associated with higher rate of aGvHD and a worse outcome.
Shamsi
Tahir Sultan
TS
Bismillah Taqee Institute of Health Sciences and Blood Diseases Centre, Karachi.
Irfan
Mohammad
M
Farzana
Tasneem
T
Ansari
Saqib Hussain
SH
Panjwani
Vinod Kumar
VK
Taj
Mevish
M
Ahmad
Ghazala
G
Shakoor
Nazmeen
N
Baig
Mirza Irfan
MI
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006680:HLA Antigens; D006402:Hematologic Diseases / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D014184:Transplantation, Homologous
D006680:HLA Antigens