Anti-leukaemic role of acute GvHD after unrelated haematopoietic stem cell transplantation in intermediate- to high-risk acute myelogenous leukaemia.
Little is known about the role of acute GvHD (aGvHD) based on the concept of graft-versus-leukaemia effect (GVLE) after unrelated donor haematopoietic stem cell transplantation (uHSCT). We evaluated 67 uHSCTs performed with multinational unrelated donors for patients with AML. The median follow-up duration was 18 months (range 7-61). The majority of patients had intermediate- or high-risk cytogenetic findings. The conditioning regimen for most patients consisted of cyclophosphamide plus total body irradiation (n=56) with our standard GvHD prophylaxis containing tacrolimus plus a short course of methotrexate. The incidence of aGvHD and chronic GvHD was 50 and 52%, respectively. Eight patients (12%) have relapsed to date. The estimated overall disease-free survival (DFS) rate at 5 years was 67%. Notably fewer relapses were seen when aGvHD developed (P=0.008). Specifically, high-risk AML patients had a much lower relapse rate when they developed aGvHD (P=0.01), compared with the intermediate-risk group. Therefore, the development of aGvHD after uHSCT in AML patients is closely related to a lower relapse rate, probably in association with GVLE.
Kim
H-J
HJ
Department of Internal Medicine, Division of Hematology, Catholic Hemopoietic Stem Cell Transplantation Center, St Mary's Hospital, Catholic University of Korea College of Medicine, Seoul, Korea.
Min
W-S
WS
Eom
K-S
KS
Cho
B-S
BS
Kim
S-Y
SY
Bok
J-N
JN
Kim
K-S
KS
Min
C-K
CK
Lee
S
S
Cho
S-G
SG
Kim
D-W
DW
Lee
J-W
JW
Kim
C-C
CC
D000293:Adolescent; D000328:Adult; D001789:Blood Group Antigens; D002869:Chromosome Aberrations; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D020544:Graft vs Leukemia Effect; D006680:HLA Antigens; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D014184:Transplantation, Homologous
D001789:Blood Group Antigens; D006680:HLA Antigens