title: Age influences post-graft-versus-host disease non-relapse mortality in adults with acute graft-versus-host disease of varying severity following allogeneic hematopoietic cell transplant.
abstract: We retrospectively analyzed 2682 patients who developed grade II-IV acute graft-versus-host disease (GVHD). On analysis with stratification into five age groups (20-29, 30-39, 40-49, 50-59 and ≥60), 2-year non-relapse mortality rates (NRM) after the onset of GVHD were 20.7, 26.2, 26.6, 37.0 and 40.4%, respectively (p<0.001). We found a significant interaction between the patient's age and GVHD severity with respect to NRM (p=0.004). On multivariate analyses stratified by GVHD severity, the hazard ratio (HR) for NRM in the groups aged 50 years or more (reference: age group 20-29) was about twice as great in patients with grade II acute GVHD when compared with grade III-IV disease (HR in those aged 50-59 years: 2.9 for grade II and 1.5 [p=0.03 and 0.04] for grades III-IV; HR if ≥60 years: 3.3 for grade II and 1.5 for grades III-IV [p<0.001 for both]).
authors: a Hematology, Graduate School of Medicine, Osaka City University , Osaka , Japan.|b GVHD working group of the Japan Society for Hematopoietic Cell Transplantation.
authors: Takahiko
authors: T
authors: Nakane
authors: b GVHD working group of the Japan Society for Hematopoietic Cell Transplantation.|c Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital , Tokyo , Japan.
authors: Takahiro
authors: T
authors: Fukuda
authors: b GVHD working group of the Japan Society for Hematopoietic Cell Transplantation.|d Division of Hematology, Saitama Medical Center, Jichi Medical University , Saitama , Japan.
authors: Junya
authors: J
authors: Kanda
authors: e Department of Hematology , Toranomon Hospital , Tokyo , Japan.
authors: Shuichi
authors: S
authors: Taniguchi
authors: f Department of Hematology , Hamanomachi Hospital , Fukuoka , Japan.
authors: Tetsuya
authors: T
authors: Eto
authors: g Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital , Tokyo , Japan.
authors: Kazuteru
authors: K
authors: Ohashi
authors: a Hematology, Graduate School of Medicine, Osaka City University , Osaka , Japan.
authors: Hirohisa
authors: H
authors: Nakamae
authors: h Department of Cell Therapy and Transplantation Medicine , University of Tokyo Hospital , Tokyo , Japan.
authors: Mineo
authors: M
authors: Kurokawa
authors: b GVHD working group of the Japan Society for Hematopoietic Cell Transplantation.|i Division of Hematology, Department of Medicine , Keio University School of Medicine , Tokyo , Japan.
authors: Takehiko
authors: T
authors: Mori
authors: b GVHD working group of the Japan Society for Hematopoietic Cell Transplantation.|j Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute , Nagoya , Japan.
authors: Yasuo
authors: Y
authors: Morishima
authors: k Department of Cell Processing and Transfusion , The Institute of Medical Science, The University of Tokyo , Japan.
authors: Tokiko
authors: T
authors: Nagamura-Inoue
authors: g Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital , Tokyo , Japan.
authors: Hisashi
authors: H
authors: Sakamaki
authors: l Department of Hematopoietic Stem Cell Transplantation Data Management and Biostatistics , Nagoya University School of Medicine , Nagoya , Japan.
authors: Yoshiko
authors: Y
authors: Atsuta
authors: b GVHD working group of the Japan Society for Hematopoietic Cell Transplantation.|m Department of Hematology and Oncology , Nagoya University Graduate School of Medicine , Nagoya , Japan.
authors: Makoto
authors: M
authors: Murata
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009026:Mortality; D017063:Outcome Assessment, Health Care; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous; D055815:Young Adult
keywords: Clinical results; graft-versus-host disease; transplant toxicity