Risk factors and organ involvement of chronic GVHD in Japan.
Few studies have evaluated the risk factors for chronic GVHD and organ involvement associated with different graft types, including unrelated cord blood (U-CB). We retrospectively studied 4818 adult patients who received their first allogeneic transplantation and survived for at least 100 days. The incidence of chronic GVHD at 2 years was 37%. The following factors were associated with the development of chronic GVHD: female donor/male recipient, CMV-Ab seropositivity, matched related peripheral blood grafts vs matched related BM grafts, no in vivo T-cell depletion and the occurrence of grade II-IV acute GVHD. Among these factors, the association with acute GVHD occurrence was consistently significant across donor subtypes. The use of U-CB was not associated with chronic GVHD, but was associated with a low incidence of extensive chronic GVHD. Chronic GVHD patients who had received U-CB transplants showed less frequent involvement of the oral cavity (28% vs 55%), eye (12% vs 26%), liver (20% vs 44%), lung (11% vs 25%) and joint (0% vs 6%) than those with matched related BM grafts. In conclusion, we found that U-CB transplants were associated with a low incidence of extensive chronic GVHD and less frequent involvement of the oral cavity, eye, liver, lung and joints.
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
J
J
Kanda
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
H
H
Nakasone
Department of Hematopoietic Stem Cell Transplantation Data Management/Biostatistics, Nagoya University School of Medicine, Nagoya, Japan.
Y
Y
Atsuta
Division of Hematology & Oncology, Department of Internal Medicine, University of Michigan Cancer Center, Ann Arbor, MI, USA.
T
T
Toubai
Division of Clinical Oncology and Hematology, Jikei University School of Medicine, Tokyo, Japan.
H
H
Yokoyama
Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
T
T
Fukuda
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
S
S
Taniguchi
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
K
K
Ohashi
Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
H
H
Ogawa
Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan.
T
T
Eto
Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
K
K
Miyamura
Division of Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Japan.
Y
Y
Morishima
Department of Cell Processing & Transfusion, Research Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
T
T
Nagamura-Inoue
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
H
H
Sakamaki
Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
M
M
Murata
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014184:Transplantation, Homologous / Q000009:adverse effects* / Q000379:methods; D061349:Unrelated Donors; D055815:Young Adult