title: Acute graft-versus-host disease. The incidence and risk factors.
abstract: OBJECTIVE
  Acute graft-versus-host-disease (aGvHD) is a major cause of mortality after allogeneic hematopoietic cell transplantation (alloHCT). The goal of this study was to evaluate the incidence and risk factors for this complication.
  
  
  METHODS
  330 consecutive patients (183 male and 147 female), aged 29 (10-56) years, treated with alloHCT in a single center between 1992-2003 were included in the analysis. AlloHCT was performed after myeloablative conditioning from either related donor (rel-HCT) (n=223) or unrelated voulnteer (URD-HCT) (n=107). GVHD prophylaxis consisted of cyclosporin, methotrexate +/- prednisolone.
  
  
  RESULTS
  Cumulative incidence of grade II-IV and grade III-IV aGvHD equaled 31% and 17%, respectively. In multivariate analysis the following factors were associated with increased risk of grade II-IV aGvHD: the diagnosis of chronic myeloid leukemia (CML) or myelodysplastic syndrome (MDS) (vs. other diagnoses), URD-HCT (vs. Rel-HCT), years of alloHCT 1992-2001 (vs. 2002-2003), donor age > or =35 years, and CD34+ cell dose > or = 4.0 x 10(6)/kg. Increased risk of grade III-IV aGVHD was associated with: the use of prednisolone for aGvHD prophylaxis, the diagnosis of CML or MDS, and CD3+ cell dose > or =100 x l0(6)/kg.
  
  
  CONCLUSIONS
  Incidence of aGvHD depends on various recipient-, donor-, and procedure-related factors. This should be taken into account when planning treatment for every individual patient.
authors.affiliation: Dept. of Haematology and Bone Marrow Transplantation, Silesian Medical University, Poland. klinhem@slam.katowice.pl
authors.forename: Jerzy
authors.initials: J
authors.lastname: Wojnar
authors.forename: Sebastian
authors.initials: S
authors.lastname: Giebel
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Krawczyk-Kulis
authors.forename: Mirosław
authors.initials: M
authors.lastname: Markiewicz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kruzel
authors.forename: Iwona
authors.initials: I
authors.lastname: Wylezol
authors.forename: Tomasz
authors.initials: T
authors.lastname: Czerw
authors.forename: Marek
authors.initials: M
authors.lastname: Seweryn
authors.forename: Jerzy
authors.initials: J
authors.lastname: Holowiecki
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007938:Leukemia / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000628:therapy; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014184:Transplantation, Homologous