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Low incidence and severity of graft-versus-host disease after outpatient allogeneic peripheral blood stem cell transplantation employing a reduced-intensity conditioning
Authors:Cantú-Rodríguez Olga G  Gutiérrez-Aguirre César H  Jaime-Pérez José C  Treviño-Montemayor Oscar R  Martínez-Cabriales Sylvia A  Gómez-Peña Alvaro  López-Otero Avril  Ruiz-Delgado Guillermo J  González-Llano Oscar  Mancías-Guerra María C  Tarín-Arzaga Luz D C  Rodríguez-Romo Laura N  Ruiz-Argüelles Guillermo J  Gómez-Almaguer David
Affiliation:Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey.
Abstract:
Background: The prevalence and features of graft‐versus‐host disease (GVHD) in patients receiving allografts using peripheral blood stem cells (PBSCs) after a reduced‐intensity conditioning (RIC) regimen are not well known. Several features of GVHD in patients at two institutions using RIC were assessed. Methods: We analysed the overall survival (OS) and prevalence of GVHD in patients who underwent outpatient allogeneic PBSC transplantation after RIC between October 1998 and July 2008. Results: We included 301 patients with a median age of 30 yrs (range, 1–71 yrs). In 37 cases, allogeneic peripheral blood stem cell transplantation was indicated for non‐malignant disease, and in 264 for malignant disease. The median OS was 35 months. The estimated 3‐yr OS was 48%. A total of 154 patients developed GVHD: there were 64 acute, 50 chronic and 40 cases that progressed from acute to chronic. Of the 104 patients with acute GVHD (aGVHD), 40% had grade I and 60% had grades II–IV. Of the 90 patients with chronic GVHD (cGVHD), 67% had limited and 33% had extensive forms. A total of 160 patients died, 40 as a result of GVHD (24 from aGVHD and 16 from cGVHD), 50 as a result of progressive disease and 70 from diverse causes. Conclusions: The incidence of GVHD was lower than in other series using conventional myeloablative preparative regimens. Most importantly, the severity of GVHD did not significantly affect the long‐term survival.
Keywords:peripheral blood stem cells  allograft transplantation  graft‐versus‐host disease
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