Outcome of patients developing GVHD after DLI given to treat CML relapse: a study by the chronic leukemia working party of the EBMT

Autor: Y, Chalandon, J R, Passweg, C, Schmid, E, Olavarria, F, Dazzi, M P, Simula, P, Ljungman, A, Schattenberg, T, de Witte, S, Lenhoff, P, Jacobs, L, Volin, S, Iacobelli, J, Finke, D, Niederwieser, C, Guglielmi, J, Pretnar
Rok vydání: 2009
Předmět:
Male
Time Factors
medicine.medical_treatment
Graft vs Host Disease
Hematopoietic stem cell transplantation
Gastroenterology
Immune Regulation [NCMLS 2]
Recurrence
Risk Factors
immune system diseases
Child
ddc:616
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
Tissue Donors
Survival Rate
Leukemia
Treatment Outcome
surgical procedures
operative
Chronic leukemia
Lymphocyte Transfusion
Child
Preschool
Female
Adult
medicine.medical_specialty
Adolescent
chemical and pharmacologic phenomena
Donor lymphocyte infusion
Settore MED/01 - Statistica Medica
Young Adult
Translational research [ONCOL 3]
Leukemia
Myelogenous
Chronic
BCR-ABL Positive
Internal medicine
Leukemia
Myelogenous
Chronic
BCR-ABL Positive/immunology/*therapy
medicine
Humans
Transplantation
Homologous
Survival rate
Proportional Hazards Models
Transplantation
business.industry
medicine.disease
Surgery
Graft-versus-host disease
Multivariate Analysis
Lymphocyte Transfusion/*adverse effects
business
Graft vs Host Disease/*etiology/immunology
Chronic myelogenous leukemia
Zdroj: Bone Marrow Transplantation, Vol. 45, No 3 (2010) pp. 558-564
Bone Marrow Transplantation, 45, 558-64
Bone Marrow Transplantation, 45, 3, pp. 558-64
ISSN: 1476-5365
0268-3369
DOI: 10.1038/bmt.2009.177
Popis: Contains fulltext : 89901.pdf (Publisher’s version ) (Closed access) We studied GVHD after donor lymphocyte infusion (DLI) in 328 patients with relapsed CML between 1991 and 2004 . A total of 122 patients (38%) developed some form of GVHD. We analyzed GVHD by clinical presentation (acute or chronic GVHD) and onset time after the first DLI (early (< or =45 days) or late (>45 days)). There was a significant overlap between onset time and clinical presentation. Some form of GVHD occurred at a median of 104 days, acute GVHD at 45 days and chronic GVHD at 181 days after DLI. The clinical presentation was acute GVHD in 71 patients, of whom 31 subsequently developed chronic GVHD subsequently. De novo chronic GVHD was seen in 51 patients. OS for all patients was 69% (95% confidence interval (CI) 63-75) at 5 years, DLI-related mortality was 11% (95% CI 8-15) and disease-related mortality was 20% (95% CI 16-25). Risk factors for developing GVHD after DLI were T-cell dose at first DLI, the time interval from transplant to DLI and donor type. In time-dependent multivariate analysis, GVHD after DLI was associated with a risk of death of 2.3-fold compared with patients without GVHD. Clinical presentation as acute GVHD and early onset GVHD were associated with increased mortality. 01 maart 2010
Databáze: OpenAIRE
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