Comparative analysis of risk factors for acute graft-versus-host disease and for chronic graft-versus-host disease according to National Institutes of Health consensus criteria.
Risk factors for grades 2-4 acute graft-versus-host disease (GVHD) and for chronic GVHD as defined by National Institutes of Health consensus criteria were evaluated and compared in 2941 recipients of first allogeneic hematopoietic cell transplantation at our center. In multivariate analyses, the profiles of risk factors for acute and chronic GVHD were similar, with some notable differences. Recipient human leukocyte antigen (HLA) mismatching and the use of unrelated donors had a greater effect on the risk of acute GVHD than on chronic GVHD, whereas the use of female donors for male recipients had a greater effect on the risk of chronic GVHD than on acute GVHD. Total body irradiation was strongly associated with acute GVHD, but had no statistically significant association with chronic GVHD, whereas grafting with mobilized blood cells was strongly associated with chronic GVHD but not with acute GVHD. Older patient age was associated with chronic GVHD, but had no effect on acute GVHD. For all risk factors associated with chronic GVHD, point estimates and confidence intervals were not significantly changed after adjustment for prior acute GVHD. These results suggest that the mechanisms involved in acute and chronic GVHD are not entirely congruent and that chronic GVHD is not simply the end stage of acute GVHD.
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA; and.
Mary E D
ME
Flowers
Yoshihiro
Y
Inamoto
Paul A
PA
Carpenter
Stephanie J
SJ
Lee
Hans-Peter
HP
Kiem
Effie W
EW
Petersdorf
Shalini E
SE
Pereira
Richard A
RA
Nash
Marco
M
Mielcarek
Matthew L
ML
Fero
Edus H
EH
Warren
Jean E
JE
Sanders
Rainer F
RF
Storb
Frederick R
FR
Appelbaum
Barry E
BE
Storer
Paul J
PJ
Martin
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D032921:Consensus; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009316:National Institutes of Health (U.S.); D012307:Risk Factors; D014481:United States; D055815:Young Adult
D007166:Immunosuppressive Agents
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