Prognostic factors of chronic graft-versus-host disease after allogeneic blood stem-cell transplantation

Steven Z. Pavletic, Lynette M Smith, Michael R. Bishop, James C. Lynch, Stefano R. Tarantolo, Julie Marie Vose, Philip Jay Bierman, Abdul Hadi, James Olen Armitage, Anne Kessinger

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Allogeneic hematopoietic stem cells in peripheral blood transplantation (alloPBSCT) or bone marrow transplantation (alloBMT) have different biological characteristics which may affect differently prognostic factors for incidence and severity of chronic graft-versus-host disease (cGVHD). To determine the prognostic factors of cGVHD in patients receiving alloPBSCT, data on 87 patients who survived at least 100 days after matched related donor myeloablative transplantation were analyzed. Factors significantly associated with higher incidence of cGVHD after alloPBSCT included CMV-positive donor, acute skin GVHD, and diagnoses other than lymphoma. Factors predictive for poor survival following cGVHD diagnosis included platelet count < 100,000/mm3 and history of acute liver GVHD. Acute liver GVHD and etoposide in the preparative regimen significantly increased risk of death due to cGVHD after alloPBSCT. All alloPBSCT multivariate models were fit to an independent cohort of comparable matched related donor alloBMT patients (n = 75). After alloBMT, only acute skin GVHD and diagnoses other than lymphoma retained prognostic significance for predicting cGVHD. Low platelet count was the only variable predictive for poor survival in cGVHD patients after alloBMT. Acute liver GVHD was the only factor that retained prognostic significance for risk of death due to cGVHD after alloBMT. These data suggest there are some cGVHD prognostic factors that may be unique to recipients of alloPBSCT. More studies are needed to determine whether cGVHD prognostic systems should be used interchangeably in patient populations receiving different stem-cell products.

Original languageEnglish (US)
Pages (from-to)265-274
Number of pages10
JournalAmerican Journal of Hematology
Volume78
Issue number4
DOIs
StatePublished - Apr 1 2005

Fingerprint

Stem Cell Transplantation
Graft vs Host Disease
Blood Cells
Bone Marrow Transplantation
Tissue Donors
Platelet Count
Liver
Lymphoma
Transplantation
Skin
Survival
Incidence
Etoposide
Hematopoietic Stem Cells
Stem Cells

Keywords

  • Allogeneic
  • Chronic
  • Graft-versus-host
  • Stem-cell transplantation

ASJC Scopus subject areas

  • Hematology

Cite this

Prognostic factors of chronic graft-versus-host disease after allogeneic blood stem-cell transplantation. / Pavletic, Steven Z.; Smith, Lynette M; Bishop, Michael R.; Lynch, James C.; Tarantolo, Stefano R.; Vose, Julie Marie; Bierman, Philip Jay; Hadi, Abdul; Armitage, James Olen; Kessinger, Anne.

In: American Journal of Hematology, Vol. 78, No. 4, 01.04.2005, p. 265-274.

Research output: Contribution to journalArticle

Pavletic, Steven Z. ; Smith, Lynette M ; Bishop, Michael R. ; Lynch, James C. ; Tarantolo, Stefano R. ; Vose, Julie Marie ; Bierman, Philip Jay ; Hadi, Abdul ; Armitage, James Olen ; Kessinger, Anne. / Prognostic factors of chronic graft-versus-host disease after allogeneic blood stem-cell transplantation. In: American Journal of Hematology. 2005 ; Vol. 78, No. 4. pp. 265-274.
@article{6c67e79b1cb54a5f954109c8e5abf69e,
title = "Prognostic factors of chronic graft-versus-host disease after allogeneic blood stem-cell transplantation",
abstract = "Allogeneic hematopoietic stem cells in peripheral blood transplantation (alloPBSCT) or bone marrow transplantation (alloBMT) have different biological characteristics which may affect differently prognostic factors for incidence and severity of chronic graft-versus-host disease (cGVHD). To determine the prognostic factors of cGVHD in patients receiving alloPBSCT, data on 87 patients who survived at least 100 days after matched related donor myeloablative transplantation were analyzed. Factors significantly associated with higher incidence of cGVHD after alloPBSCT included CMV-positive donor, acute skin GVHD, and diagnoses other than lymphoma. Factors predictive for poor survival following cGVHD diagnosis included platelet count < 100,000/mm3 and history of acute liver GVHD. Acute liver GVHD and etoposide in the preparative regimen significantly increased risk of death due to cGVHD after alloPBSCT. All alloPBSCT multivariate models were fit to an independent cohort of comparable matched related donor alloBMT patients (n = 75). After alloBMT, only acute skin GVHD and diagnoses other than lymphoma retained prognostic significance for predicting cGVHD. Low platelet count was the only variable predictive for poor survival in cGVHD patients after alloBMT. Acute liver GVHD was the only factor that retained prognostic significance for risk of death due to cGVHD after alloBMT. These data suggest there are some cGVHD prognostic factors that may be unique to recipients of alloPBSCT. More studies are needed to determine whether cGVHD prognostic systems should be used interchangeably in patient populations receiving different stem-cell products.",
keywords = "Allogeneic, Chronic, Graft-versus-host, Stem-cell transplantation",
author = "Pavletic, {Steven Z.} and Smith, {Lynette M} and Bishop, {Michael R.} and Lynch, {James C.} and Tarantolo, {Stefano R.} and Vose, {Julie Marie} and Bierman, {Philip Jay} and Abdul Hadi and Armitage, {James Olen} and Anne Kessinger",
year = "2005",
month = "4",
day = "1",
doi = "10.1002/ajh.20275",
language = "English (US)",
volume = "78",
pages = "265--274",
journal = "American Journal of Hematology",
issn = "0361-8609",
publisher = "Wiley-Liss Inc.",
number = "4",

}

TY - JOUR

T1 - Prognostic factors of chronic graft-versus-host disease after allogeneic blood stem-cell transplantation

AU - Pavletic, Steven Z.

AU - Smith, Lynette M

AU - Bishop, Michael R.

AU - Lynch, James C.

AU - Tarantolo, Stefano R.

AU - Vose, Julie Marie

AU - Bierman, Philip Jay

AU - Hadi, Abdul

AU - Armitage, James Olen

AU - Kessinger, Anne

PY - 2005/4/1

Y1 - 2005/4/1

N2 - Allogeneic hematopoietic stem cells in peripheral blood transplantation (alloPBSCT) or bone marrow transplantation (alloBMT) have different biological characteristics which may affect differently prognostic factors for incidence and severity of chronic graft-versus-host disease (cGVHD). To determine the prognostic factors of cGVHD in patients receiving alloPBSCT, data on 87 patients who survived at least 100 days after matched related donor myeloablative transplantation were analyzed. Factors significantly associated with higher incidence of cGVHD after alloPBSCT included CMV-positive donor, acute skin GVHD, and diagnoses other than lymphoma. Factors predictive for poor survival following cGVHD diagnosis included platelet count < 100,000/mm3 and history of acute liver GVHD. Acute liver GVHD and etoposide in the preparative regimen significantly increased risk of death due to cGVHD after alloPBSCT. All alloPBSCT multivariate models were fit to an independent cohort of comparable matched related donor alloBMT patients (n = 75). After alloBMT, only acute skin GVHD and diagnoses other than lymphoma retained prognostic significance for predicting cGVHD. Low platelet count was the only variable predictive for poor survival in cGVHD patients after alloBMT. Acute liver GVHD was the only factor that retained prognostic significance for risk of death due to cGVHD after alloBMT. These data suggest there are some cGVHD prognostic factors that may be unique to recipients of alloPBSCT. More studies are needed to determine whether cGVHD prognostic systems should be used interchangeably in patient populations receiving different stem-cell products.

AB - Allogeneic hematopoietic stem cells in peripheral blood transplantation (alloPBSCT) or bone marrow transplantation (alloBMT) have different biological characteristics which may affect differently prognostic factors for incidence and severity of chronic graft-versus-host disease (cGVHD). To determine the prognostic factors of cGVHD in patients receiving alloPBSCT, data on 87 patients who survived at least 100 days after matched related donor myeloablative transplantation were analyzed. Factors significantly associated with higher incidence of cGVHD after alloPBSCT included CMV-positive donor, acute skin GVHD, and diagnoses other than lymphoma. Factors predictive for poor survival following cGVHD diagnosis included platelet count < 100,000/mm3 and history of acute liver GVHD. Acute liver GVHD and etoposide in the preparative regimen significantly increased risk of death due to cGVHD after alloPBSCT. All alloPBSCT multivariate models were fit to an independent cohort of comparable matched related donor alloBMT patients (n = 75). After alloBMT, only acute skin GVHD and diagnoses other than lymphoma retained prognostic significance for predicting cGVHD. Low platelet count was the only variable predictive for poor survival in cGVHD patients after alloBMT. Acute liver GVHD was the only factor that retained prognostic significance for risk of death due to cGVHD after alloBMT. These data suggest there are some cGVHD prognostic factors that may be unique to recipients of alloPBSCT. More studies are needed to determine whether cGVHD prognostic systems should be used interchangeably in patient populations receiving different stem-cell products.

KW - Allogeneic

KW - Chronic

KW - Graft-versus-host

KW - Stem-cell transplantation

UR - http://www.scopus.com/inward/record.url?scp=20144389614&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20144389614&partnerID=8YFLogxK

U2 - 10.1002/ajh.20275

DO - 10.1002/ajh.20275

M3 - Article

C2 - 15795914

AN - SCOPUS:20144389614

VL - 78

SP - 265

EP - 274

JO - American Journal of Hematology

JF - American Journal of Hematology

SN - 0361-8609

IS - 4

ER -