PMID- 18981462
OWN - NLM
STAT- MEDLINE
DCOM- 20090106
LR  - 20240316
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 26
IP  - 35
DP  - 2008 Dec 10
TI  - Risk factors for acute graft-versus-host disease after human leukocyte 
      antigen-identical sibling transplants for adults with leukemia.
PG  - 5728-34
LID - 10.1200/JCO.2008.17.6545 [doi]
AB  - PURPOSE: Acute graft-versus-host disease (GVHD) causes substantial morbidity and 
      mortality after human leukocyte antigen (HLA)-identical sibling transplants. No 
      large registry studies of acute GVHD risk factors have been reported in two 
      decades. Risk factors may have changed in this interval as transplant-related 
      techniques have evolved. PATIENTS AND METHODS: Acute GVHD risk factors were 
      analyzed in 1,960 adults after HLA-identical sibling myeloablative transplant for 
      acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), or chronic 
      myeloid leukemia (CML) reported by 226 centers worldwide to the Center for 
      International Blood and Marrow Transplant Research from 1995 to 2002. Outcome was 
      measured as time from transplant to onset of grade 2 to 4 acute GVHD, with death 
      without acute GVHD as a competing risk. RESULTS: Cumulative incidence of grade 2 
      to 4 acute GVHD was 35% (95% CI, 33% to 37%). In multivariable analyses, factors 
      significantly associated with grade 2 to 4 acute GVHD were cyclophosphamide + 
      total-body irradiation versus busulfan + cyclophosphamide (relative risk [RR] = 
      1.4; P < .0001), blood cell versus bone marrow grafts in patients age 18 to 39 
      years (RR = 1.43; P = .0023), recipient age 40 and older versus age 18 to 39 
      years receiving bone marrow grafts (RR = 1.44; P = .0005), CML versus AML/ALL (RR 
      = 1.35; P = .0003), white/Black versus Asian/Hispanic race (RR = 1.54; P = 
      .0003), Karnofsky performance score less than 90 versus 90 to 100 (RR = 1.27; P = 
      .014), and recipient/donor cytomegalovirus-seronegative versus either positive 
      (RR = 1.20; P = .04). Stratification by disease showed the same significant 
      predictors of grade 2 to 4 acute GVHD for CML; however, KPS and cytomegalovirus 
      serostatus were not significant predictors for AML/ALL. CONCLUSION: This analysis 
      confirmed several previously reported risk factors for grade 2 to 4 acute GVHD. 
      However, several new factors were identified whereas others are no longer 
      significant. These new data may facilitate individualized risk estimates and 
      raise several interesting biologic questions.
FAU - Hahn, Theresa
AU  - Hahn T
AD  - Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, USA. 
      Theresa.hahn@roswellpark.org
FAU - McCarthy, Philip L Jr
AU  - McCarthy PL Jr
FAU - Zhang, Mei-Jie
AU  - Zhang MJ
FAU - Wang, Dan
AU  - Wang D
FAU - Arora, Mukta
AU  - Arora M
FAU - Frangoul, Haydar
AU  - Frangoul H
FAU - Gale, Robert Peter
AU  - Gale RP
FAU - Hale, Gregory A
AU  - Hale GA
FAU - Horan, John
AU  - Horan J
FAU - Isola, Luis
AU  - Isola L
FAU - Maziarz, Richard T
AU  - Maziarz RT
FAU - van Rood, Jon J
AU  - van Rood JJ
FAU - Gupta, Vikas
AU  - Gupta V
FAU - Halter, Joerg
AU  - Halter J
FAU - Reddy, Vijay
AU  - Reddy V
FAU - Tiberghien, Pierre
AU  - Tiberghien P
FAU - Litzow, Mark
AU  - Litzow M
FAU - Anasetti, Claudio
AU  - Anasetti C
FAU - Pavletic, Stephen
AU  - Pavletic S
FAU - Ringden, Olle
AU  - Ringden O
LA  - eng
GR  - U24 CA076518/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20081103
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Bone Marrow Transplantation/*adverse effects
MH  - Canada
MH  - Europe
MH  - Female
MH  - Graft vs Host Disease/*etiology/mortality
MH  - HLA Antigens/*analysis
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Leukemia/immunology/*surgery
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/immunology/surgery
MH  - Leukemia, Myeloid, Acute/immunology/surgery
MH  - *Living Donors
MH  - Male
MH  - Peripheral Blood Stem Cell Transplantation/*adverse effects
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology/surgery
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - *Siblings
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States
MH  - Young Adult
PMC - PMC2645611
EDAT- 2008/11/05 09:00
MHDA- 2009/01/07 09:00
PMCR- 2009/12/10
CRDT- 2008/11/05 09:00
PHST- 2008/11/05 09:00 [pubmed]
PHST- 2009/01/07 09:00 [medline]
PHST- 2008/11/05 09:00 [entrez]
PHST- 2009/12/10 00:00 [pmc-release]
AID - JCO.2008.17.6545 [pii]
AID - 76545 [pii]
AID - 10.1200/JCO.2008.17.6545 [doi]
PST - ppublish
SO  - J Clin Oncol. 2008 Dec 10;26(35):5728-34. doi: 10.1200/JCO.2008.17.6545. Epub 
      2008 Nov 3.