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
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
复制标题
DOI：
10.1182/blood-2010-08-302109
复制
发表时间：
2011-03-17
期刊：
影响因子：
20.3
通讯作者：
Martin, Paul J.
中科院分区：
文献类型：
--
作者：
Flowers, Mary E. D.;Inamoto, Yoshihiro;Martin, Paul J.
在本中心的2941例首次异基因造血细胞移植受者中，评估并比较了2-4级急性移植物抗宿主病（GVHD）和慢性GVHD（根据美国国立卫生研究院共识标准定义）的危险因素。在多变量分析中，急性和慢性GVHD的危险因素特征相似，但存在一些显着差异。人类白细胞抗原（HLA）错配和使用无关供体对急性GVHD风险的影响大于慢性GVHD，而使用女性供体对男性受体的慢性GVHD风险的影响大于急性GVHD。全身照射与急性GVHD密切相关，但与慢性GVHD无统计学显著相关性，而动员血细胞移植与慢性GVHD密切相关，但与急性GVHD无关。年龄较大的患者与慢性GVHD相关，但对急性GVHD没有影响。对于所有与慢性GVHD相关的危险因素，校正既往急性GVHD后，点估计值和置信区间均无显著变化。这些结果表明，在急性和慢性GVHD涉及的机制是不完全一致的，慢性GVHD是不简单的急性GVHD的终末期。（血。2011; 117（11）：3214-3219）
Risk factors for grades 2-4 acute graft-versus-host disease (GVHD) and for chronic GVHD as defined by National Institutes of Health consensus criteria were evaluated and compared in 2941 recipients of first allogeneic hematopoietic cell transplantation at our center. In multivariate analyses, the profiles of risk factors for acute and chronic GVHD were similar, with some notable differences. Recipient human leukocyte antigen (HLA) mismatching and the use of unrelated donors had a greater effect on the risk of acute GVHD than on chronic GVHD, whereas the use of female donors for male recipients had a greater effect on the risk of chronic GVHD than on acute GVHD. Total body irradiation was strongly associated with acute GVHD, but had no statistically significant association with chronic GVHD, whereas grafting with mobilized blood cells was strongly associated with chronic GVHD but not with acute GVHD. Older patient age was associated with chronic GVHD, but had no effect on acute GVHD. For all risk factors associated with chronic GVHD, point estimates and confidence intervals were not significantly changed after adjustment for prior acute GVHD. These results suggest that the mechanisms involved in acute and chronic GVHD are not entirely congruent and that chronic GVHD is not simply the end stage of acute GVHD. (Blood. 2011; 117(11): 3214-3219)