TY - JOUR
T1 - Acute graft-versus-host disease in pediatric allogeneic hematopoietic stem cell transplantation. Single-center experience during 10 yr
AU - Faraci, Maura
AU - Caviglia, Ilaria
AU - Biral, Erika
AU - Morreale, Giuseppe
AU - Giardino, Stefano
AU - Garbarino, Lucia
AU - Castagnola, Elio
AU - Dini, Giorgio
AU - Lanino, Edoardo
PY - 2012/12
Y1 - 2012/12
N2 - a-GvHD may complicate allogeneic HSCT. In this retrospective single-center study, we evaluated incidence and risk factors of a-GvHD in 197 consecutive allogeneic pediatric HSCTs applying Glucksberg and NIH a-GvHD classifications. Among 179 eligible transplants, the cumulative incidence of grade 0-I a-GvHD was 48% and grade II-IV was 52%. None of the considered variables significantly influenced the incidence of grade II-IV a-GvHD. Malignancy and myeloablation were associated with an increased risk of classic a-GvHD (p <0.01). Seventy-two percentage of children are alive, with a significant difference in OS and TRM between grade 0 and I vs. grade II and IV a-GvHD; this observation was reproduced in the non-malignant setting, while only a disparity in TRM was evidenced in children with malignancy. In our experience, the incidence of a-GvHD was similar, regardless of donor type. Myeloablation and malignant disease represented the only risk factors for classic a-GvHD. Our results highlight the need for a better prevention of this complication in the non-malignant setting.
AB - a-GvHD may complicate allogeneic HSCT. In this retrospective single-center study, we evaluated incidence and risk factors of a-GvHD in 197 consecutive allogeneic pediatric HSCTs applying Glucksberg and NIH a-GvHD classifications. Among 179 eligible transplants, the cumulative incidence of grade 0-I a-GvHD was 48% and grade II-IV was 52%. None of the considered variables significantly influenced the incidence of grade II-IV a-GvHD. Malignancy and myeloablation were associated with an increased risk of classic a-GvHD (p <0.01). Seventy-two percentage of children are alive, with a significant difference in OS and TRM between grade 0 and I vs. grade II and IV a-GvHD; this observation was reproduced in the non-malignant setting, while only a disparity in TRM was evidenced in children with malignancy. In our experience, the incidence of a-GvHD was similar, regardless of donor type. Myeloablation and malignant disease represented the only risk factors for classic a-GvHD. Our results highlight the need for a better prevention of this complication in the non-malignant setting.
KW - acute graft-versus-host disease
KW - children
KW - refractory acute graft-versus-host disease
KW - unrelated and related donor
UR - http://www.scopus.com/inward/record.url?scp=84868681598&partnerID=8YFLogxK
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U2 - 10.1111/petr.12009
DO - 10.1111/petr.12009
M3 - Article
C2 - 23131057
AN - SCOPUS:84868681598
VL - 16
SP - 887
EP - 893
JO - Pediatric Transplantation
JF - Pediatric Transplantation
SN - 1397-3142
IS - 8
ER -