Español Incidence of acute graft-versus-host disease in the patients with matched sibling donor hematopoietic stem cell transplant at a medical center
DOI:
https://doi.org/10.35509/01239015.893Keywords:
Graft vs host disease, hematopoietic stem cell transplantation, donor selectionAbstract
Objective: Acute graft-versus-host disease (aGVHD) is one of the complications of allogeneic hematopoietic stem cell transplantation (AHSCT). This study aims to describe the incidence and prognostic factors of aGVHD in adult patients receiving matched sibling donor AHSCT.
Methods: Between 2015 and 2018, a retrospective cohort study was carried out with patients undergoing AHSCT from matched sibling donor at a medical center in the city of Bogotá, Colombia.
Results: The incidence of aGVHD was 59.79 % (n=58). In the univariate and multivariate Cox regression analysis, the female sex of the donor was a prognostic factor (p=0.04 and p=0.004, respectively). Likewise, myeloablative conditioning (HR=2.43, p=0.0230), prophylaxis other than cyclophosphamide (HR=2.48, p=0.0290), and donor age (HR=1.02, p=0.0200) were evidenced as independent predictors of aGVHD. Regarding relapse-free survival after one year, the difference between patients with aGVHD and without aGVHD was 90.51% and 63.94%, respectively (p=0.0014). Similarly, it was found that patients with aGVHD GI-II had an overall survival of 85.71%, while patients with GVHD GIII-IV had a lower rate of 63.64% (ꭓ2=0.0633).
Conclusions: The incidence of aGVHD in our study is similar to those found in previous studies. The development of aGVHD decreased the risk of relapse and impacted the one-year progression-free survival, but overall survival improvement was limited to patients with aGVHD GI-II.
Author Biographies
Angie Paola Guarín-Castañeda, Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
1. Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
Gloria Elena Mora-Figueroa, Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
1. Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
Enrique Pedraza-Mesa, Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
1. Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
Javier Leonardo Figueroa-Camacho, Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
1. Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
Óscar Javier Peña-Ardila, Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
1. Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
María José López-Mora, Infectología, Clínica de Marly, Bogotá, D. C., Colombia.
2. Infectología, Clínica de Marly, Bogotá, D. C., Colombia.
Paula Lucía Pinzón-Leal, Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
1. Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
César Augusto Lamadrid-Sastre, Medicina General, Clínica de Marly, Bogotá, D. C., Colombia.
3. Medicina General, Clínica de Marly, Bogotá, D. C., Colombia.
Gustavo Adolfo López-Castañeda, Medicina General, Clínica de Marly, Bogotá, D. C., Colombia.
3. Medicina General, Clínica de Marly, Bogotá, D. C., Colombia.
Francy Licet Villamizar-Gómez, Epidemiología Clínica, Clínica de Marly, Bogotá, D. C., Colombia
4. Epidemiología Clínica, Clínica de Marly, Bogotá, D. C., Colombia
Carlos Fernando Gómez-Calcetero, Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
1. Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
Mauricio Efraín Gómez-Ortiz, Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
1. Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
Sergio Felipe Ardila, Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
1. Hematología, Clínica de Marly, Bogotá, D. C., Colombia.
Herman Esguerra, Oncología, Radioterapia, Clínica de Marly, Bogotá, D. C., Colombia
5. Oncología, Radioterapia, Clínica de Marly, Bogotá, D. C., Colombia
References
Blazar BR, MacDonald KPA, Hill GR. Immune regulatory cell infusion for graft-versus-host disease prevention and therapy. Blood. 2018;131(24):2651-60. https://doi.org/10.1182/blood-2017-11-785865
Harris AC, Young R, Devine S, Hogan WJ, Ayuk F, Bunworasate U, et al. International, multicenter standardization of acute graft-versus-host disease clinical data collection: A report from the Mount Sinai acute GVHD International Consortium. Biol Blood Marrow Transplant. 2016;22(1):4-10.https://doi.org/10.1016/j.bbmt.2015.09.001
Schoemans HM, Lee SJ, Ferrara JL, Wolff D, Levine JE, Schultz KR, et al. EBMT-NIH-CIBMTR Task Force position statement on standardized terminology & guidance for graft-versus-host disease assessment. Bone Marrow Transplant. 2018;53(11):1401-15. https://doi.org/10.1038/s41409-018-0204-7
Saliba RM, de Lima M, Giralt S, Andersson B, Khouri IF, Hosing C, et al. Hyperacute GVHD: risk factors, outcomes, and clinical implications. Blood. 2007;109(7):2751-8. https://doi.org/10.1182/blood-2006-07-034348
Mielcarek M, Martin PJ, Leisenring W, Flowers ME, Maloney DG, Sandmaier BM, et al. Graft-versus-host disease after nonmyeloablative versus conventional hematopoietic stem cell transplantation. Blood. 2003;102(2):756-62. https://doi.org/10.1182/blood-2002-08-2628
Aladağ E, Kelkitli E, Göker H. Acute graft-versus-host disease: A brief review. Turk J Haematol. 2020;37(1):1-4. https://doi.org/10.4274/tjh.galenos.2019.2019.0157
Lee SE, Cho BS, Kim JH, Yoon JH, Shin SH, Yahng SA, et al. Risk and prognostic factors for acute GVHD based on NIH consensus criteria. Bone Marrow Transplant. 2013;48(4):587-92. https://doi.org/10.1038/bmt.2012.187
Flowers ME, Inamoto Y, Carpenter PA, Lee SJ, Kiem HP, Petersdorf EW, et al. Comparative analysis of risk factors for acute graft-versus-host disease and for chronic graft-versus-host disease according to National Institutes of Health consensus criteria. Blood. 2011;117(11):3214-9. https://doi.org/10.1182/blood-2010-08-302109
Jagasia M, Arora M, Flowers ME, Chao NJ, McCarthy PL, Cutler CS, et al. Risk factors for acute GVHD and survival after hematopoietic cell transplantation. Blood. 2012;119(1):296-307. https://doi.org/10.1182/blood-2011-06-364265
Yu J, Parasuraman S, Shah A, Weisdorf D. Mortality, length of stay and costs associated with acute graft-versus-host disease during hospitalization for allogeneic hematopoietic stem cell transplantation. Curr Med Res Opin. 2019;35(6):983-8. https://doi.org/10.1080/03007995.2018.1551193
Majhail NS. Long-term complications after hematopoietic cell transplantation. Hematol Oncol Stem Cell Ther. 2017;10(4):220-7. https://doi.org/10.1016/j.hemonc.2017.05.009
Sorror ML, Storb RF, Sandmaier BM, Maziarz RT, Pulsipher MA, Maris MB, et al. Storer comorbidity-age index: A clinical measure of biologic age before allogeneic hematopoietic cell transplantation. J Clin Oncol. 2014;32(29):3249-56. https://doi.org/10.1200/JCO.2013.53.8157
Armand P, Kim HT, Logan BR, Wang Z, Alyea EP, Kalaycio ME, et al. Validation and refinement of the Disease Risk Index for allogeneic stem cell transplantation. Blood. 2014;123(23):3664-71. https://doi.org/10.1182/sangre-2014-01-552984
National Institutes of Health National Cancer Institute. Common terminology criteria for adverse events (CTCAE) Version 5.0 [Internet]. Adverse Events/CTCAE. [citado: 2021 jul 7]. Available from: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcae_v5_quick_reference_5x7.pdf
Medina D, González L, Davalos D, Rosales M, Estacio M, Manzi E. Trasplante de células madre hematopoyéticas en pacientes pediátricos con diagnóstico de neoplasias mieloides, experiencia en 15 años. Rev Colomb Cancerol. 2018;22(2):69-75. https://doi.org/10.1016/j.rccan.2018.05.004
Omer AK, Weisdorf DJ, Lazaryan A, Shanley R, Blazar BR, MacMillan ML, et al. Late acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2016;22(5):879-83. https://doi.org/10.1016/j.bbmt.2015.12.020
Wang F, Cai B, Wang L, Gu Z, Luo L, Wei H, et al. Risk factors for acute graft-versus-host disease after allogeneic haematopoietic stem cell transplantation: A single-center experience. Ann Transplant. 2017;22:58-65. https://doi.org/10.12659/aot.901495
El Fakih R, Hashmi SK, Ciurea SO, Luznik L, Gale RP, Aljurf M. Post-transplant cyclophosphamide use in matched HLA donors: a review of literature and future application. Bone Marrow Transplant. 2020;55(1):40-7. https://doi.org/10.1038/s41409-019-0547-8
Fraser CJ, Bhatia S, Ness K, Carter A, Francisco L, Arora M, et al. Impact of chronic graft-versus-host disease on the health status of hematopoietic cell transplantation survivors: a report from the Bone Marrow Transplant Survivor Study. Blood. 2006;108(8):2867-73. https://doi.org/10.1182/blood-2006-02-003954
McCurdy SR, Kanakry CG, Tsai HL, Gojo I, Smith BD, Gladstone DE, et al. Development of grade ii acute graft-versus-host disease is associated with improved survival after myeloablative HLA-matched bone marrow transplantation using single-agent post-transplant cyclophosphamide. Biol Blood Marrow Transplant. 2019;25(6):1128-35. https://doi.org/10.1016/j.bbmt.2018.12.767
How to Cite
Downloads
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Revista Colombiana de Cancerología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Todos los derechos reservados.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
