title: Graft versus host disease in allogeneic stem cell transplantation--3 1/2 years experience.
abstract: OBJECTIVE
  To evaluate the frequency and outcome of graft versus host disease after allogeneic stem cell transplant in haematological disorders at Armed Forces Bone Marrow Transplant Centre, Rawalpindi from July 2001 to December 2004.
  
  
  METHODS
  Eighty-six patients with various haematological disorders namely aplastic anaemia (n=32), b-Thalassaemia (n=25), CML (n=22), ALL (n=3), AML (n=1) Fanconi's anaemia (n=2), and Gaucher's disease (n=1), underwent allogeneic stem cell transplantation. All patients received cyclosoprin, prednisolone and short course of methotrexate as GvHD prophylaxis. The patients who developed acute GvHD > grade-II or chronic extensive GvHD received steroids at a starting dose of 2 mg/kg body weight along with gradual increase in cyclosporine dosage (max dose 12.5 mg/kg).
  
  
  RESULTS
  The overall incidence of acute GvHD grade-II to IV was 44.2% (n=38/86) where as the incidence of chronic extensive GvHD was 14% (n=12/86). Acute GvHD was 68% (n=17/25) in beta-Thalassaemia, 50% (n=11/22) in CML, 50% (n=2/4) in Acute Leukaemias and 25% (n=8/32) in Aplastic Anaemia. Chronic GvHD was 25% (n=1/4) in Acute Leukaemias, 18.8% (n=6/32) in Aplastic Anaemia, 18.2% (n=4/22) in CML and 4% (n=1/25) in beta-Thalassaemia. The overall survival in acute GvHD was 84.2% (n=32) where as the overall survival in chronic GvHD was 50% (n=6). The overall mortality in acute GvHD was 15.8% (n=6) and 50% in chronic GvHD (n=6).
  
  
  CONCLUSIONS
  The morbidity and mortality due to severe acute and chronic GvHD remains high despite standard prophylaxis against GvHD. New strategies are needed to prevent and treat GvHD.
authors.affiliation: Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan.
authors.forename: KhalilUllah
authors.initials: K
authors.lastname: Hashmi
authors.forename: Badshah
authors.initials: B
authors.lastname: Khan
authors.forename: Parvez
authors.initials: P
authors.lastname: Ahmed
authors.forename: Iftikhar
authors.initials: I
authors.lastname: Hussain
authors.forename: Choudhry
authors.initials: C
authors.lastname: Altaf
authors.forename: Shahid
authors.initials: S
authors.lastname: Raza
authors.forename: Hamid
authors.initials: H
authors.lastname: Iqbal
authors.forename: Mehreen Ali
authors.initials: MA
authors.lastname: Khan
authors.forename: Hamid Saeed
authors.initials: HS
authors.lastname: Malik
authors.forename: Muhammad
authors.initials: M
authors.lastname: Naeem
authors.forename: Khalid
authors.initials: K
authors.lastname: Kamal
authors.forename: Masood
authors.initials: M
authors.lastname: Anwar
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000453:epidemiology; D006402:Hematologic Diseases / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine