title: Risk and prognostic factors for acute GVHD based on NIH consensus criteria.
abstract: To investigate the risk factors for acute GVHD (aGVHD), based on NIH consensus criteria (NCC), we evaluated 775 patients who underwent allogeneic transplantation. Of them, 346 patients developed aGVHD by NCC, in whom we also analyzed factors affecting aGVHD-specific survival. The cumulative incidence of aGVHD was 44.7%, consisting of classic aGVHD (n=320) and late-onset (n=26). Multivariate analyses revealed that younger age (P=0.015), unrelated donors (P=0.004) and acute leukemia compared with other hematologic malignancies (P=0.005) were significant risk factors for aGVHD, whereas PBSCs showed no association (P=0.720). Multivariate analyses, with only aGVHD patients, revealed that late-onset aGVHD had superior aGVHD-specific survival to classic aGVHD (P=0.044), and identified the association of visceral organ involvement (P=0.002), severity of aGVHD at onset (P=0.035) and advanced disease status (P<0.001) with inferior aGVHD-specific survival. In conclusion, this study demonstrates the risk and prognostic factors for aGVHD by NCC with some differences with the previous reports that were based on old criteria. The difference in the risk factors according to different criteria will give insights about the pathophysiology of GVHD. The better prognosis of late-onset aGVHD than of classic aGVHD raises the necessity for prospective trials with a large cohort focusing on the onset time.
authors.affiliation: Department of Internal Medicine, Division of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: S-E
authors.initials: SE
authors.lastname: Lee
authors.forename: B-S
authors.initials: BS
authors.lastname: Cho
authors.forename: J-H
authors.initials: JH
authors.lastname: Kim
authors.forename: J-H
authors.initials: JH
authors.lastname: Yoon
authors.forename: S-H
authors.initials: SH
authors.lastname: Shin
authors.forename: S-A
authors.initials: SA
authors.lastname: Yahng
authors.forename: K-S
authors.initials: KS
authors.lastname: Eom
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Kim
authors.forename: H-J
authors.initials: HJ
authors.lastname: Kim
authors.forename: S
authors.initials: S
authors.lastname: Lee
authors.forename: C-K
authors.initials: CK
authors.lastname: Min
authors.forename: S-G
authors.initials: SG
authors.lastname: Cho
authors.forename: D-W
authors.initials: DW
authors.lastname: Kim
authors.forename: J-W
authors.initials: JW
authors.lastname: Lee
authors.forename: W-S
authors.initials: WS
authors.lastname: Min
authors.forename: C-W
authors.initials: CW
authors.lastname: Park
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D032921:Consensus; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014184:Transplantation, Homologous