title: Risk Factors, Pattern and Clinical Outcome of Acute Graft Versus Host Disease in Acute Leukemia Patients Undergoing Allogeneic Stem Cell Transplant.
abstract: We sought to determine risk factors, pattern and outcome of acute graft versus host disease (aGVHD) in seventy-seven acute leukemia patients who underwent allogeneic stem cell transplant at our centre from January 2008 to March 2013. GVHD prophylaxis with cyclosporine-methotrexate or cyclosporine-mycophenolate mofetil was used. Patients were divided in 2 groups, grade II-IV aGVHD (group A) and grade 0-I aGVHD (group B). Incidence of any grade and grade II-IV aGVHD was 44 and 18 %, respectively. The most common site of aGVHD was gastro-intestinal tract (65 %) followed by skin (35 %). Higher total nucleated cell (TNC) dose infused was associated with increased incidence of grade II-IV aGVHD. Incidence of relapse and incidence of slippage of chimerism was 21 and 36 % in group A while 37 and 27 % in group B respectively. Transplant related mortality (TRM) was 21 % in group A and 13 % in group B. Probability of OS and RFS at 4 years was 63 and 34 % in group A compared with 40 and 38 % in group B, respectively. We conclude that higher TNC dose infused is a risk factor for grade II-IV aGVHD with gut being the commonest site. Grade II-IV aGVHD did not have a significant impact on incidence of relapse, TRM and OS.
authors: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210 India.
authors: Alok
authors: A
authors: Gupta
authors: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210 India.
authors: Sachin
authors: S
authors: Punatar
authors: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210 India.
authors: Jayant
authors: J
authors: Gawande
authors: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210 India.
authors: Libin
authors: L
authors: Mathew
authors: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210 India.
authors: Bhausaheb
authors: B
authors: Bagal
authors: Department of Biostatistics, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, India.
authors: Sadhana
authors: S
authors: Kannan
authors: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210 India.
authors: Navin
authors: N
authors: Khattry
keywords: Acute graft-versus-host disease; Acute leukemia; Allogeneic stem cell transplantation; GVHD prophylaxis; Transplant outcome