title: [A comparison of clinical characteristics and prognosis of adult acute graft-versus-host disease between human leukocyte antigen- identical and -mismatched allogeneic hematopoietic stem cell transplantation].
abstract: OBJECTIVE
  To compare the clinical characteristics and prognosis of acute graft-versus-host disease (aGVHD) between patients undergoing human leukocyte antigen (HLA)-identical and HLA-mismatched allogeneic hematopoietic stem cell transplantation (allo-HSCT).
  
  
  METHODS
  Clinical data of 544 patients receiving related allo-HSCT in Institute of Hematology of Peking University from January 2010 to December 2011 were retrospectively analyzed. The clinical features of aGVHD including manifestations and prognosis between HLA-identical and HLA-mismatched transplantation were compared.
  
  
  RESULTS
  The cumulative incidence of aGVHD in related HLA-mismatched transplant was 50.2%, which was significantly higher than that of HLA-identical transplant (20.4%, P < 0.001). However, the cumulative incidence of grade III°-IV° aGVHD between the two groups was comparable (4.5% vs 6.8%, P = 0.066). Gut aGVHD accounted for 31.1% in HLA-identical transplant while cutaneous aGVHD was the dominant area in HLA-mismatched transplant (66.5%). The incidence of gut and liver aGVHD in HLA-mismatched patients was also lower than that in HLA-identical patients. The proportion of patients with aGVHD accompanied by fever was higher in HLA-mismatched patients than in HLA-identical patients (47.6% vs 28.9%, P = 0.028). The cure rate of aGVHD in identical transplant was lower than that in mismatched transplant, especially for grade III°-IV° aGVHD. The complete remission rate after second-line anti-GVHD therapies was lower than that of mismatched transplant (88.9% vs 98.8%, P = 0.006). More patients died of aGVHD in identical transplant compared with mismatched transplant (11.1% vs 2.4%, P = 0.024).
  
  
  CONCLUSIONS
  More patients who received HLA-mismatched allo-HSCT develop into aGVHD compared with HLA-identical transplant. But the incidence of severe aGVHD between HLA-identical and -mismatched is comparable. The overall cure rate of HLA-mismatched transplant is significantly higher than that of HLA-identical transplant.
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Xiaosu
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Lanping
authors.initials: L
authors.lastname: Xu
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Daihong
authors.initials: D
authors.lastname: Liu
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Han
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Chenhua
authors.initials: C
authors.lastname: Yan
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Chen
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Han
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Jingzhi
authors.initials: J
authors.lastname: Wang
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Zhao
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Xiangyu
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Kaiyan
authors.initials: K
authors.lastname: Liu
authors.affiliation: Institute of Hematology and People's Hospital, Peking University, Beijing 100044, China. Email: xjhrm@medmail.com.cn.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology*; D006680:HLA Antigens / Q000235:genetics*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens