title: Acute graft-versus-host disease in pediatric allogeneic hematopoietic stem cell transplantation. Single-center experience during 10 yr.
abstract: a-GvHD may complicate allogeneic HSCT. In this retrospective single-center study, we evaluated incidence and risk factors of a-GvHD in 197 consecutive allogeneic pediatric HSCTs applying Glucksberg and NIH a-GvHD classifications. Among 179 eligible transplants, the cumulative incidence of grade 0-I a-GvHD was 48% and grade II-IV was 52%. None of the considered variables significantly influenced the incidence of grade II-IV a-GvHD. Malignancy and myeloablation were associated with an increased risk of classic a-GvHD (p < 0.01). Seventy-two percentage of children are alive, with a significant difference in OS and TRM between grade 0 and I vs. grade II and IV a-GvHD; this observation was reproduced in the non-malignant setting, while only a disparity in TRM was evidenced in children with malignancy. In our experience, the incidence of a-GvHD was similar, regardless of donor type. Myeloablation and malignant disease represented the only risk factors for classic a-GvHD. Our results highlight the need for a better prevention of this complication in the non-malignant setting.
authors.affiliation: Hematopoietic Stem Cell Transplantation Unit, Haematology-Oncology Department, G. Gaslini Children's Research Institute, Genova, Italy. maurafaraci@ospedale-gaslini.ge.it
authors.forename: Maura
authors.initials: M
authors.lastname: Faraci
authors.forename: Ilaria
authors.initials: I
authors.lastname: Caviglia
authors.forename: Erika
authors.initials: E
authors.lastname: Biral
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morreale
authors.forename: Stefano
authors.initials: S
authors.lastname: Giardino
authors.forename: Lucia
authors.initials: L
authors.lastname: Garbarino
authors.forename: Elio
authors.initials: E
authors.lastname: Castagnola
authors.forename: Giorgio
authors.initials: G
authors.lastname: Dini
authors.forename: Edoardo
authors.initials: E
authors.lastname: Lanino
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007223:Infant; D008297:Male; D011336:Probability; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D013234:Stem Cells / Q000166:cytology; D013256:Steroids / Q000494:pharmacology; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids