title: Characteristics of chronic GVHD after cord blood transplantation.
abstract: Most reports of chronic GVHD after cord blood transplantation (CBT) have utilized traditional diagnostic criteria. We used traditional criteria and National Institutes of Health (NIH) criteria prospectively to evaluate chronic GVHD in a cohort of 87 adult and pediatric recipients of single or double unrelated CBT for treatment of hematologic malignancies. Fifty-four patients developed traditionally defined chronic GVHD, for an estimated 2-year probability of 64%. Among 54 patients, 25 (46%) met the NIH criteria for persistent, recurrent or late acute GVHD at onset. Twenty-four (44%) had overlap chronic GVHD, including one who presented initially with late acute GVHD, and only seven (13%) had classic chronic GVHD, including one who also presented initially with late acute GVHD. Among patients who successfully discontinued all systemic immunosuppression (SI), the median time to discontinuation of corticosteroid treatment was 315 days (range 28-977), and the median time to discontinuation of all SI was 353 days (range 67-977). Chronic GVHD diagnosed by traditional criteria after CBT had a predominance of acute GVHD clinical features.
authors.affiliation: 1] Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA, USA [2] Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA [3] Division of Hematology and Medical Oncology, Department of Medicine, Oregon Health and Science University (OHSU) Knight Cancer Institute, Portland, OR, USA.
authors.forename: L F
authors.initials: LF
authors.lastname: Newell
authors.forename: M E D
authors.initials: ME
authors.lastname: Flowers
authors.forename: T A
authors.initials: TA
authors.lastname: Gooley
authors.forename: F
authors.initials: F
authors.lastname: Milano
authors.forename: P A
authors.initials: PA
authors.lastname: Carpenter
authors.forename: P J
authors.initials: PJ
authors.lastname: Martin
authors.forename: C
authors.initials: C
authors.lastname: Delaney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014181:Transplantation Immunology; D014184:Transplantation, Homologous; D055815:Young Adult