Risk factors associated with the development of moderate to severe chronic graft-versus-host disease after non-myeloablative conditioning allogeneic stem cell transplantation in patients with AML or MDS

• Published in: Human cell : official journal of Human Cell Research Society Vol. 33; no. 1; pp. 243 - 251
• Main Authors: Kok, Laurence M. C., Bungener, Laura, de Bock, Geertruida H., Biswana, Anouschka, van der Wal, Geertiena, van Imhoff, Gustaaf W., Bellido, Mar
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.01.2020; Springer Nature B.V
• Subjects: Acute myeloid leukemia; Antibodies; Biomedical and Life Sciences; CD19 antigen; CD3 antigen; CD34 antigen; Cell Biology; Graft-versus-host reaction; Gynecology; Histocompatibility antigen HLA; Life Sciences; Morbidity; Myelodysplastic syndrome; Myeloid leukemia; Oncology; Quality of life; Reproductive Medicine; Research Article; Risk factors; Serology; Stem cell transplantation; Stem Cells; Surgery; Chronic graft-versus-host disease; Moderate to severe; Non-myeloablative; PBSCT; Risk factors
• ISSN: 1749-0774; 0914-7470; 1749-0774
• DOI: 10.1007/s13577-019-00297-7

Moderate to severe chronic graft-versus-host disease (cGVHD) is associated with high morbidity, hospital dependency and poor quality of life. In this study, we analyzed a well-defined consecutive series of 98 patients with acute myelogenous leukemia/myelodysplastic syndrome (AML/MDS) who received allogeneic stem cell transplantation with non-myeloablative (NMA) conditioning to determine risk factors associated with the severity of cGVHD. cGVHD was defined according to the 2005 National Institute of Health consensus criteria. Transfusions before transplantation, presence of HLA antibodies, composition of the graft (CD3+, CD19+, CD34+ cells), sibling or matched unrelated donor, female donor to male recipient, CMV serology and the development of acute GVHD (aGVHD), were considered potential risk factors. Multivariate Cox regression analysis identified the number of CD19+ 10 6 /kg (HR 2.79; 95% CI 1.35–5.74), CD3+ 10 6 /kg (HR 2.18; 95% CI 1.04–4.59) infused cells and the presence of patient HLA antibodies before transplantation (HR 2.34; CI 1.11–4.95) as significant risk factors for the development of moderate to severe cGVHD. In summary, we identified in a small, but well-defined cohort, 3 risk factors associated with the severity of cGVHD that should be validated in a larger multi-center study.