Risk Factors for Acute Graft-Versus-Host Disease After Allogeneic Haematopoietic Stem Cell Transplantation: A Single-Center Experience.
BACKGROUND Acute graft-versus-host disease (aGVHD) remains the most common and challenging complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). An important obstacle to the therapeutic effect of aGVHD is the inability to identify risk factors for an individual patient at the onset of symptoms. We performed a retrospective study with the aim of defining clinically meaningful pre-transplantation risk factors for grades II-IV aGVHD patients. MATERIAL AND METHODS To identify pre-transplantation risk factors for grades II-IV aGVHD after allo-HSCT, we performed a retrospective study in 292 patients who underwent allo-HSCT at our center from January 2010 to July 2015. RESULTS The cumulative incidence of grades II-IV aGVHD was 36.6±2.8%. The most common target organ of aGVHD was the skin (46.7%), followed by the gastrointestinal tract (29.9%). The risk factors we identified included HLA-mismatched related donors (odds ratio [OR], 3.21; 95% confidence interval [CI], 1.82-5.67) and conditioning regimens containing TBI but no ATG (OR, 2.66; 95% CI, 1.40-5.06). Simultaneously, transplantation with an identical sibling donor (OR, 0.31; 95% CI, 0.18-0.55) and the use of ATG in the conditioning regimen containing TBI (OR 0.37; 95% CI, 0.15-0.93) were two factors found to be associated with a decreased risk of grades II-IV aGVHD. CONCLUSIONS Our study suggests that pre-transplantation characteristics of donor and recipient play an important role in identifying patients at high risk for grades II-IV aGVHD, which provide a direction for the prevention and treatment of aGVHD in the future.
Department of Haematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Feiyan
F
Wang
Department of Haematology, The 307th Hospital of Chinese People's Liberation Army, Beijing, China (mainland).
Bo
B
Cai
Department of Haematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Li
L
Wang
Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Zhenyang
Z
Gu
Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Lan
L
Luo
Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Huaping
H
Wei
Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Shasha
S
Zhao
Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Lixun
L
Guan
Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Xiaoyu
X
Wang
Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Lili
L
Wang
Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Daihong
D
Liu
Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Chunji
C
Gao
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000009:adverse effects*; D055815:Young Adult