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Risk assessment and outcome of chronic graft-versus-host disease after allogeneic peripheral blood progenitor cell transplantation in pediatric patients.
Bone Marrow Transplant. 2004 Sep; 34(5):433-8.BM

Abstract

We retrospectively evaluated the incidence, risk factors for chronic graft-versus-host disease (cGvHD) and outcome in 80 pediatric patients (36 male) (median age 13 years) who underwent allogeneic peripheral blood progenitor cell transplantation. Patients were grafted from an HLA-identical sibling after myeloablative conditioning (total body irradiation (TBI) based 52; non-TBI 28). GvHD prophylaxis used were: cyclosporin A (CsA)+ short methotrexate (MTX) in 52 and CsA+/-prednisone in 28. The median number of CD34+ cells infused were 5.8 x 10(6)/kg (range: 1.4-32.8). The median follow-up was 24 months (range: 3-94). In all, 28 patients had cGvHD (confidence interval (CI): 54.2+/-10%). Factors that were significant on univariate analysis were diagnosis (P=0.03) and GvHD prophylaxis administered (P=0.04). On multivariate analysis, only GvHD prophylaxis used was associated with a significant risk of cGvHD (hazard ratio (HR): 3.94; 95% CI: 1.41-10.91, P=0.009). The CI of cGvHD for patients receiving CsA+MTX was 40.9+/-12 vs 76.5+/-18% for patients who did not (P=0.03). The probability of relapse was 36+/-6% for all patients (12.5+/-8% for patients with cGvHD vs 47.9+/-8% without cGvHD). The probability of disease-free survival was better for patients with cGvHD (69.9+/-10 vs 37.9+/-7%; HR: 3.59, 95% CI: 1.47-5.56; P=0.001). Our data suggest that the GvHD prophylaxis used is the most relevant predictor of cGvHD. Patients with cGvHD had a lower risk of relapse and a better survival.

Authors+Show Affiliations

Hospital Infantil 'Niño Jesus', Madrid, Spain. mdiaz@hnjs.insalud.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15273704

Citation

Diaz, M A., et al. "Risk Assessment and Outcome of Chronic Graft-versus-host Disease After Allogeneic Peripheral Blood Progenitor Cell Transplantation in Pediatric Patients." Bone Marrow Transplantation, vol. 34, no. 5, 2004, pp. 433-8.
Diaz MA, Vicent MG, Gonzalez ME, et al. Risk assessment and outcome of chronic graft-versus-host disease after allogeneic peripheral blood progenitor cell transplantation in pediatric patients. Bone Marrow Transplant. 2004;34(5):433-8.
Diaz, M. A., Vicent, M. G., Gonzalez, M. E., Verdeguer, A., de la Rubia, J., Bargay, J., de Arriba, F., Diez, J. L., Caballero, D., Madero, L., & Brunet, S. (2004). Risk assessment and outcome of chronic graft-versus-host disease after allogeneic peripheral blood progenitor cell transplantation in pediatric patients. Bone Marrow Transplantation, 34(5), 433-8.
Diaz MA, et al. Risk Assessment and Outcome of Chronic Graft-versus-host Disease After Allogeneic Peripheral Blood Progenitor Cell Transplantation in Pediatric Patients. Bone Marrow Transplant. 2004;34(5):433-8. PubMed PMID: 15273704.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk assessment and outcome of chronic graft-versus-host disease after allogeneic peripheral blood progenitor cell transplantation in pediatric patients. AU - Diaz,M A, AU - Vicent,M G, AU - Gonzalez,M E, AU - Verdeguer,A, AU - de la Rubia,J, AU - Bargay,J, AU - de Arriba,F, AU - Diez,J L, AU - Caballero,D, AU - Madero,L, AU - Brunet,S, AU - ,, PY - 2004/7/27/pubmed PY - 2005/2/3/medline PY - 2004/7/27/entrez SP - 433 EP - 8 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 34 IS - 5 N2 - We retrospectively evaluated the incidence, risk factors for chronic graft-versus-host disease (cGvHD) and outcome in 80 pediatric patients (36 male) (median age 13 years) who underwent allogeneic peripheral blood progenitor cell transplantation. Patients were grafted from an HLA-identical sibling after myeloablative conditioning (total body irradiation (TBI) based 52; non-TBI 28). GvHD prophylaxis used were: cyclosporin A (CsA)+ short methotrexate (MTX) in 52 and CsA+/-prednisone in 28. The median number of CD34+ cells infused were 5.8 x 10(6)/kg (range: 1.4-32.8). The median follow-up was 24 months (range: 3-94). In all, 28 patients had cGvHD (confidence interval (CI): 54.2+/-10%). Factors that were significant on univariate analysis were diagnosis (P=0.03) and GvHD prophylaxis administered (P=0.04). On multivariate analysis, only GvHD prophylaxis used was associated with a significant risk of cGvHD (hazard ratio (HR): 3.94; 95% CI: 1.41-10.91, P=0.009). The CI of cGvHD for patients receiving CsA+MTX was 40.9+/-12 vs 76.5+/-18% for patients who did not (P=0.03). The probability of relapse was 36+/-6% for all patients (12.5+/-8% for patients with cGvHD vs 47.9+/-8% without cGvHD). The probability of disease-free survival was better for patients with cGvHD (69.9+/-10 vs 37.9+/-7%; HR: 3.59, 95% CI: 1.47-5.56; P=0.001). Our data suggest that the GvHD prophylaxis used is the most relevant predictor of cGvHD. Patients with cGvHD had a lower risk of relapse and a better survival. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/15273704/Risk_assessment_and_outcome_of_chronic_graft_versus_host_disease_after_allogeneic_peripheral_blood_progenitor_cell_transplantation_in_pediatric_patients_ L2 - https://doi.org/10.1038/sj.bmt.1704589 DB - PRIME DP - Unbound Medicine ER -