title: Acute GVHD after allogeneic hematopoietic transplantation affects early marrow reconstitution and speed of engraftment.
abstract: Our aim was to study the influence of acute graft-versus-host disease (a-GVHD) on primary engraftment times after allogeneic transplantation. Primary engraftment and frequency of marrow granulocyte-macrophage colony-forming units and erythroid burst-forming units, at day +18, were studied in 126 allogeneic transplants. Patients were grouped according to the time when a-GVHD treatment with corticosteroids was started. The no-a-GVHD group are those who, during the first 3 months, had no need for a-GVHD treatment; the early-a-GVHD group are those who needed a-GVHD treatment within 19 days; and the postengraftment-a-GVHD group are those who were not on corticosteroid treatment at the time of engraftment but needed it after day +19. The no-a-GVHD group reached a neutrophil count (N) > 0.5 × 10(9)/L in a median of 17.8 days. The postengraftment-a-GVHD group reached N > 0.5 × 10(9)/L in a median of 21.4 days (p = 0.0003). The early-a-GVHD group had N > 0.5 × 10(9)/L in a median of +17.0 days (p = 0.23). When factors important for engraftment were studied in a multivariate analysis, postengraftment a-GVHD was a significant factor in delayed neutrophil and platelet engraftment. Both the early-a-GVHD and postengraftment-a-GVHD groups showed a significant reduction in frequency of granulocyte-macrophage colony-forming units and erythroid burst-forming units found in marrow at day +18. In conclusion, a-GVHD may influence early marrow reconstitution and is a relevant factor for primary myeloid and platelet engraftment.
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy. Electronic address: giuseppe.milone@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Milone
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Camuglia
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Avola
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Annalia
authors.initials: A
authors.lastname: Di Marco
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Leotta
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cupri
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Spina
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Romano
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Spina
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Azzaro
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Deja
authors.initials: D
authors.lastname: Berritta
authors.affiliation: Department of Hematology, Hematopoietic Transplantation Program, Azienda Ospedaliera Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Parisi
authors.affiliation: Section of Epidemiology, Clinical Physiology Institute Centro Nazionale Delle Ricerche, Reggio Calabria, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tripepi
mesh_terms: D001792:Blood Platelets / Q000473:pathology; D001854:Bone Marrow Cells / Q000473:pathology*; D016026:Bone Marrow Transplantation; D006086:Graft vs Host Disease; D006801:Humans; D009504:Neutrophils / Q000473:pathology; D014184:Transplantation, Homologous