title: [Effect of graft-versus-host disease on relapse and survival in 100 patients after allogeneic hematopoietic stem cell transplantation].
abstract: The study was aimed to investigate the incidences and risk factors of acute and chronic graft-versus-host diseases (GVHD) and to clarify their effects on relapse and survival of recipients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The clinical data of 100 cases of allo-HSCT were retrospectively analyzed. The incidences and risk factors of aGVHD and cGVHD, relapse and survival were studied. The results showed that 31 cases developed aGVHD of II - IV grade (34.4%) and 14 cases developed aGVHD of III - IV grade (17.7%). HLA matched or mismatched did not show significant difference in the development of aGVHD of II - IV grade (p > 0.05). Previous occurrence of aGVHD was the risk factor for cGVHD (HR = 2.303, p = 0.088). The female was a favorable factor for cGVHD (HR = 0.401, p = 0.055). The relapse rate was lower in patients who developed cGVHD. The development of aGVHD of II - IV grade was the risk factor for overall survival (p < 0.05). The mortality of patients with aGVHD of III - IV grade and mortality of patients with aGVHD of 0 - I grade were 81.0% and 35.7% respectively, there was very significant difference between them (p = 0.000). In conclusion, till now GVHD and graft-versus-leukemia (GVL) effect can not be separated. The positive effect of GVL could be counteracted by GVHD-related mortality. It is necessary to prevent and control the development of severe aGVHD. The development of local cGVHD may be beneficial to the long-term disease-free survival of patients after allo-HSCT.
authors.affiliation: Department of Hematology, Peking University First Hospital, Beijing 100034, China.
authors.forename: Xue-Rong
authors.initials: XR
authors.lastname: Deng
authors.forename: Han-Yun
authors.initials: HY
authors.lastname: Ren
authors.forename: Xi-Nan
authors.initials: XN
authors.lastname: Cen
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Wang
authors.forename: Ze-Yin
authors.initials: ZY
authors.lastname: Liang
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Wang
authors.forename: Zhi-Xiang
authors.initials: ZX
authors.lastname: Qiu
authors.forename: Jin-Ping
authors.initials: JP
authors.lastname: Ou
authors.forename: Wei-Lin
authors.initials: WL
authors.lastname: Xu
authors.forename: Mang-Ju
authors.initials: MJ
authors.lastname: Wang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Yue
authors.initials: Y
authors.lastname: Yin
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology* / Q000401:mortality*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult