Characterization of acute graft-versus-host disease following reduced-intensity stem-cell transplantation from an HLA-identical related donor

Naoko Murashige, Masahiro Kami, Shin Ichiro Mori, Yuta Katayama, Kazuhiko Kobayashi, Yasushi Onishi, Akiko Hori, Yukiko Kishi, Tamae Hamaki, Kinuko Tajima, Yoshinobu Kanda, Ryuji Tanosaki, Yoichi Takaue

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2 Citations (Scopus)

Abstract

To investigate clinical features of acute graft-versus-host disease (GVHD) following reduced intensity stem-cell transplantation (RIST), we retrospectively investigated medical records of 65 patients with hematologic malignancies who underwent RIST from a matched related donor. Preparative regimen comprised fludarabine 30 mg/m2 (n = 53) or cladribine 0.11 mg/kg (n = 12) for 6 days plus busulfan 4 mg/kg for 2 days. Twelve patients received rabbit antithymocyte globulin 2.5 mg/kg/day for 2-4 consecutive days. Grade II to IV acute GVHD was diagnosed in 36 patients (55%). Its median onset was day 58 (range, 17-109), while it was bimodal, peaking day 15-29 (early-onset GVHD, n = 18) and day 75-89 days (late-onset GVHD, n = 18). Variables that were more common in early-onset GVHD than late-onset GVHD included skin rash (89% vs. 61%) and noninfectious fevers (33% vs. 11%). Desaturation, pulmonary infiltrates and hyperbilirubinemia (>2.0 mg/dL) were more common in late-onset GVHD (6% vs. 22%, 0% vs. 17%, and 6% vs. 33%, respectively). All of the patients with early-onset GVHD given corticosteroid responded to it, while 5 of the 18 patients with late-onset GVHD failed to respond it. Patients with either early-onset or late-onset GVHD tended to have better progression-free survival (PFS) than those without it; however, there was no significant difference in PFS between patients with early-onset GVHD and those with late-onset GVHD. This study suggests that several etiologies might have contributed to the development of acute GVHD following RIST.

Original languageEnglish
Pages (from-to)630-634
Number of pages5
JournalAmerican Journal of Hematology
Volume83
Issue number8
DOIs
Publication statusPublished - 2008 Aug 1
Externally publishedYes

ASJC Scopus subject areas

  • Hematology

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    Murashige, N., Kami, M., Mori, S. I., Katayama, Y., Kobayashi, K., Onishi, Y., Hori, A., Kishi, Y., Hamaki, T., Tajima, K., Kanda, Y., Tanosaki, R., & Takaue, Y. (2008). Characterization of acute graft-versus-host disease following reduced-intensity stem-cell transplantation from an HLA-identical related donor. American Journal of Hematology, 83(8), 630-634. https://doi.org/10.1002/ajh.21197