PMID- 24674726
OWN - NLM
STAT- MEDLINE
DCOM- 20150411
LR  - 20140328
IS  - 0578-1426 (Print)
IS  - 0578-1426 (Linking)
VI  - 53
IP  - 1
DP  - 2014 Jan
TI  - [A comparison of clinical characteristics and prognosis of adult acute 
      graft-versus-host disease between human leukocyte antigen- identical and 
      -mismatched allogeneic hematopoietic stem cell transplantation].
PG  - 35-9
AB  - OBJECTIVE: To compare the clinical characteristics and prognosis of acute 
      graft-versus-host disease (aGVHD) between patients undergoing human leukocyte 
      antigen (HLA)-identical and HLA-mismatched allogeneic hematopoietic stem cell 
      transplantation (allo-HSCT). METHODS: Clinical data of 544 patients receiving 
      related allo-HSCT in Institute of Hematology of Peking University from January 
      2010 to December 2011 were retrospectively analyzed. The clinical features of 
      aGVHD including manifestations and prognosis between HLA-identical and 
      HLA-mismatched transplantation were compared. RESULTS: The cumulative incidence 
      of aGVHD in related HLA-mismatched transplant was 50.2%, which was significantly 
      higher than that of HLA-identical transplant (20.4%, P < 0.001). However, the 
      cumulative incidence of grade III degrees -IV degrees  aGVHD between the two groups was 
      comparable (4.5% vs 6.8%, P = 0.066). Gut aGVHD accounted for 31.1% in 
      HLA-identical transplant while cutaneous aGVHD was the dominant area in 
      HLA-mismatched transplant (66.5%). The incidence of gut and liver aGVHD in 
      HLA-mismatched patients was also lower than that in HLA-identical patients. The 
      proportion of patients with aGVHD accompanied by fever was higher in 
      HLA-mismatched patients than in HLA-identical patients (47.6% vs 28.9%, P = 
      0.028). The cure rate of aGVHD in identical transplant was lower than that in 
      mismatched transplant, especially for grade III degrees -IV degrees  aGVHD. The complete 
      remission rate after second-line anti-GVHD therapies was lower than that of 
      mismatched transplant (88.9% vs 98.8%, P = 0.006). More patients died of aGVHD in 
      identical transplant compared with mismatched transplant (11.1% vs 2.4%, P = 
      0.024). CONCLUSION: More patients who received HLA-mismatched allo-HSCT develop 
      into aGVHD compared with HLA-identical transplant. But the incidence of severe 
      aGVHD between HLA-identical and -mismatched is comparable. The overall cure rate 
      of HLA-mismatched transplant is significantly higher than that of HLA-identical 
      transplant.
FAU - Zhao, Xiaosu
AU  - Zhao X
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Xu, Lanping
AU  - Xu L
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Liu, Daihong
AU  - Liu D
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Han, Tingting
AU  - Han T
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Wang, Yu
AU  - Wang Y
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Zhang, Xiaohui
AU  - Zhang X
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Yan, Chenhua
AU  - Yan C
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Chen, Huan
AU  - Chen H
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Han, Wei
AU  - Han W
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Wang, Jingzhi
AU  - Wang J
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Zhao, Ting
AU  - Zhao T
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Li, Yan
AU  - Li Y
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Zhang, Bo
AU  - Zhang B
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Zhao, Xiangyu
AU  - Zhao X
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Liu, Kaiyan
AU  - Liu K
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China.
FAU - Huang, Xiaojun
AU  - Huang X
AD  - Institute of Hematology and People's Hospital, Peking University, Beijing 100044, 
      China. Email: xjhrm@medmail.com.cn.
LA  - chi
PT  - Comparative Study
PT  - English Abstract
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Zhonghua Nei Ke Za Zhi
JT  - Zhonghua nei ke za zhi
JID - 16210490R
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Graft vs Host Disease/diagnosis/*etiology
MH  - HLA Antigens/*genetics
MH  - Hematopoietic Stem Cell Transplantation/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Transplantation, Homologous
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2014/03/29 06:00
MHDA- 2015/04/12 06:00
CRDT- 2014/03/29 06:00
PHST- 2014/03/29 06:00 [entrez]
PHST- 2014/03/29 06:00 [pubmed]
PHST- 2015/04/12 06:00 [medline]
PST - ppublish
SO  - Zhonghua Nei Ke Za Zhi. 2014 Jan;53(1):35-9.