Korean J Hematol.  2006 Jun;41(2):92-98. 10.5045/kjh.2006.41.2.92.

Graft-Versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation with Non-Myeloablative Conditioning: Experiences at a Single Center

• Na II
• Shin H
• Song EK
• Lee KW
• Yun T
• Kim JH
• Yoon SS
• Lee JS
• Park S
• Kim BK

• KMID: 2083482
• DOI: http://doi.org/10.5045/kjh.2006.41.2.92

Abstract

BACKGROUND: The use of non-myeloablative stem cell transplantation (NST) has recently been increasing for treating the patients who cannot tolerate ablative hematopoietic stem cell transplantation (HSCT). Although graft-versus-host disease (GVHD) is one of the greatest problems in HSCT, the clinical effect of GVHD following NST is not clear. We undertook this study to evaluate the clinical manifestations of GVHD and the outcomes after NST.
METHODS
From October 2000 to October 2004, 61 patients underwent NST with a fludarabine-based conditioning regimen. The cumulative incidence of GVHD and the survival rates were obtained from the Kaplan-Meier curves.
RESULTS
With a median follow-up of 195 days, the estimate for overall three-year survival was 32%. The cumulative incidences of grades II~IV acute GVHD and chronic GVHD were 33% (18/53) and 78% (29/37), respectively. The response rates for acute and chronic GVHD were 33% and 89%, respectively. The survival rates of patients with acute and chronic GVHD were 27% and 89%, respectively. The median survival time was 6.5 months
CONCLUSION
The incidence of GVHD after NST did not differ from that after ablative HSCT. This study suggests that the aggressive treatment of acute GVHD should be considered to improve the overall survival after NST.

Keyword

Hematopoietic stem cell; Non-myeloablative transplantation; Graft-versus-host disease; Preparative regimen

MeSH Terms

Follow-Up Studies
Graft vs Host Disease*
Hematopoietic Stem Cell Transplantation*
Hematopoietic Stem Cells*
Humans
Incidence
Stem Cell Transplantation
Survival Rate

Figure

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  Fig. 1 Kaplan-Meier survival curve of overall survival after NST.

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  Fig. 2 Cumulative incidence of grade II～IV acute GVHD (A) and chronic GVHD (B).

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  Fig. 3 Survival curves of acute (A) and chronic (B) GVHD under immunosuppressive treatment.

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