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An analysis of the effect of chronic GvHD on relapse and survival following allogeneic PBSC transplantation

Bell, A. et al. (2000) An analysis of the effect of chronic GvHD on relapse and survival following allogeneic PBSC transplantation. Cytotherapy, 2 (6). pp. 423-428. ISSN 1465-3249

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Abstract

Background PBSC are increasingly being used as the source of stem cells in allogeneic transplantation. An increased incidence of chronic GvHD has been suggested following unmanipulated, allogeneic PBSC transplantation (PBSCT), however; how this affects overall survival is not yet clear. Our aim was to study the impact of chronic GvHD on survival and relapse following allogeneic PBSCT. Methods We have analyzed data from 73 patients undergoing HLA-matched allogeneic PBSCT. GvHD prophylaxis was with CYA and MTX in 97% of patients. We have studied the incidence of chronic GvHD and its affect on relapse and survival in these patients. All patients were at least 100 days post-transplant at the time a analysis. Results Seventy-three patients were evaluable for analysis of chronic GvHD. The overall incidence a chronic GvHD was 55% (limited in 18% and extensive in 37%). Overall median survival was 991 days, with a 4year survival rate of 48%. Twelve patients relapsed Patients with chronic GvHD had a significantly lower incidence of disease relapse (p = 0.005) with a relapse probability of 8% at 3 years compared with 40% in patients with no chronic GvHD. In addition, the extent of chronic GvHD had a marked effect on survival patients with limited chronic GvHD had a 4 year survival rate of 83%, compared with 45% in patients with extensive chronic GvHD and 38% in patients with no chronic GvHD. This difference was primarily due to the low incidence of relapse and low mortality seen in patients with limited chronic GvHD. Discussion The presence and extent a chronic GvHD is an important predictor of outcome following allogeneic PBSCT, in that patients who developed either limited or extensive chronic GvHD had a low risk a disease relapse.

Item Type:Article
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Franklin, Prof Ian
Authors: Bell, A., Cook, G., Franklin, I., Hutchinson, R., Marsh, J., Miflin, G., Milligan, D., Morgan, G., Pagliuca, A., Potter, M., and Russell, N.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine > Clinical Specialities
Journal Name:Cytotherapy
ISSN:1465-3249

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