title: [Effect of chronic graft versus host disease on relapse and survival in patients with acute myeloid leukemia].
abstract: OBJECTIVE
  To explore the influence of relapse and survival by chronic graft versus host disease (cGVHD) in patients with acute myeloid leukemia (AML) after allogeneic hematopoietics stem cell transplantation (allo-HSCT).
  
  
  METHODS
  Fifty-five AML patients received allo-HSCT were retrospectively reviewed. Relapse rate and overall survival (OS) were analyzed according to cGVHD.
  
  
  RESULTS
  cGVHD significantly decreased the relapse rate of AML patients after transplantation within 2 years when compared with those without cGVHD (8.7% vs 38.6%, P=0.019), however, cGVHD had no effect on the long-term relapse rate (22.8% vs 5.9%, P=0.217). cGVHD had no effect on OS within 2 years (78.3% vs 61.0%, P=0.155) but could decrease the rate of long-term survival (63.7% vs 100%,P=0.01). cGVHD also could reduce the rate of relapse (8.3% vs 46.2%, P=0.044) and enhanced the rate of survival (83.3% vs 47.2%, P=0.045) in patients with high risk AML after allo-HSCT in 2 years, while it had no effect on the relapse rate and OS in patients with low and intermediated risk AML in early and late phase. Moreover, compared with the rate of relapse(38.6%) in patients without cGVHD, the rate of relapse were lower in patients with limited cGVHD and intensive cGVHD (27.3% and 31.3%, respectively) but the long-term survival was significantly lower (53.3%, P=0.001) in those patients with intensive cGVHD after all-HSCT.
  
  
  CONCLUSIONS
  The benefit effect of cGVHD mainly took place within 2 years after allo-HSCT in AML patients especially in those with high risk, while in late phase after allo-HSCT, cGVHD especially intensive cGVHD had an effect on reducing long-term survival.
authors.affiliation: Department of Hematology,Chinese PLA General Hospital, Beijing 100853,China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Hematology,Chinese PLA General Hospital, Beijing 100853,China.
authors.forename: Huaping
authors.initials: H
authors.lastname: Wei
authors.affiliation: Department of Hematology,Chinese PLA General Hospital, Beijing 100853,China.
authors.forename: Shasha
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Hematology,Chinese PLA General Hospital, Beijing 100853,China.
authors.forename: Honghua
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Hematology,Chinese PLA General Hospital, Beijing 100853,China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Jing
authors.affiliation: Department of Hematology,Chinese PLA General Hospital, Beijing 100853,China.
authors.forename: Wenrong
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Hematology,Chinese PLA General Hospital, Beijing 100853,China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Hematology,Chinese PLA General Hospital, Beijing 100853,China.
authors.forename: Quanshun
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Hematology,Chinese PLA General Hospital, Beijing 100853,China.
authors.forename: Li
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Hematology,Chinese PLA General Hospital, Beijing 100853,China.
authors.forename: Chunji
authors.initials: C
authors.lastname: Gao
mesh_terms: D002908:Chronic Disease; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute; D012008:Recurrence; D012189:Retrospective Studies; D014184:Transplantation, Homologous