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Risk factors for acute GVHD and survival after hematopoietic cell transplantation
Open accessAbstract
Risk factors for acute GVHD (AGVHD), overall survival, and transplant-related mortality were evaluated in adults receiving allogeneic hematopoietic cell transplants (1999-2005) from HLA-identical sibling donors (SDs; n = 3191) or unrelated donors (URDs; n = 2370) and reported to the Center for International Blood and Marrow Transplant Research, Minneapolis, MN. To understand the impact of transplant regimen on AGVHD risk, 6 treatment categories were evaluated: (1) myeloablative conditioning (MA) with total body irradiation (TBI) + PBSCs, (2) MA + TBI + BM, (3) MA + nonTBI + PBSCs, (4) MA + nonTBI + BM, (5) reduced intensity conditioning (RIC) + PBSCs, and (6) RIC + BM. The cumulative incidences of grades B-D AGVHD were 39% (95% confidence interval [CI], 37%-41%) in the SD cohort and 59% (95% CI, 57%-61%) in the URD cohort. Patients receiving SD transplants with MA + nonTBI + BM and RIC + PBSCs had significantly lower risks of grades B-D AGVHD than patients in other treatment categories. Those receiving URD transplants with MA + TBI + BM, MA + nonTBI + BM, RIC + BM, or RIC + PBSCs had lower risks of grades B-D AGVHD than those in other treatment categories. The 5-year probabilities of survival were 46% (95% CI, 44%-49%) with SD transplants and 33% (95% CI, 31%-35%) with URD transplants. Conditioning intensity, TBI and graft source have a combined effect on risk of AGVHD that must be considered in deciding on a treatment strategy for individual patients.
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Acute Graft-versus-Host Disease — Biologic Process, Prevention, and Therapy
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Intestinal Blautia Is Associated with Reduced Death from Graft-versus-Host Disease
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TFOS DEWS II iatrogenic report
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ST2 as a Marker for Risk of Therapy-Resistant Graft-versus-Host Disease and Death
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Metadata
- Authors
- Jagasia, M., Arora, M., Flowers, M. E. D., Chao, N. J., McCarthy, P. L., Cutler, C. S., Urbano-Ispizua, A., Pavletic, S. Z., Haagenson, M. D., Zhang, M.-J., Antin, J. H., Bolwell, B. J., Bredeson, C., Cahn, J.-Y., Cairo, M., Gale, R. P., Gupta, V., Lee, S. J., Litzow, M., Weisdorf, D. J., Horowitz, M. M., & Hahn, T.
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2012-01-05
- Volume
- 119
- Issue
- 1
- Pages
- 296-307
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- OpenAlex
- W2045254759
- Cited by
- 707
- References
- 32
- FWCI
- 15.47
- Type
- journal article
- Language
- en
- Open access
- green
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- Jagasia, M., Arora, M., Flowers, M. E. D., Chao, N. J., McCarthy, P. L., Cutler, C. S., Urbano-Ispizua, A., Pavletic, S. Z., Haagenson, M. D., Zhang, M.-J., Antin, J. H., Bolwell, B. J., Bredeson, C., Cahn, J.-Y., Cairo, M., Gale, R. P., Gupta, V., Lee, S. J., Litzow, M., . . . Hahn, T. (2012). Risk factors for acute GVHD and survival after hematopoietic cell transplantation. Blood. https://doi.org/10.1182/blood-2011-06-364265
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