The Clinical Research Of Chronic Graft-versus-host Disease After Allogeneic Hematopoietic Stem Cell Transplantation

[Objective]Chronic graft versus host disease(cGVHD) remain to be one of the major complication occurring after allogeneic hematopoietic stem cell transplantation(allo-HSCT). To investigate the high risk elements analysis of chronic graft versus host disease.Explore early diagnosis of late-onset noninfectious pulmonary complications(LNIPC).To guide the early diagnosis and treatment of cGVHD.The study also explored the role of B-cell activating factor(BAFF) Which can be used to dynamic monitoring and treating cGVHD.[Methods]The incidence of cGVHD occuring was observed in 160 patients underwent Allo-HSCT in our hospital.The diagnose of cGVHD was clinically confirmed,Analysis patients" clinical manifestation and high risk elements.Explore the incidence and high risk factors of late-onset noninfectious pulmonary complications.Typically we derived peripheral blood from the 25 patients after Allo-HSCT.Using flow cytometry,the levels of B-cell activating factor were counted.The clinical data was collected and analysis between cGVHD group and without cGVHD group.[Results]We found that cGVHD was developed in 55 cases(34.4%) of 160 patients underwent Allo-HSCT in our hospital.16 patients died of progressive cGVHD or complicated infection.Mortality was 10%(10/160).We found that cGVHD was strongly associated with HLA mismatch,occurred aGVHD,primary diagnosed CML,and recipient's older age.While the high risk factors of late-onset noninfectious pulmonary complications were advanced stage of disease at transplantation and extensive cGVHD(P＜0.05).The ratio of BAFF in patients with cGVHD was much higher than the patients without cGVHD (P=0.03).[Conclusion]The high risk factors of cGVHD were HLA mismatch,occurred aGVHD, primary diagnosed CML,and recipient's older age.After transplantation performing pulmonary function test(PFT) and thoracic computer tomography should be taken routinely. Most patients who get correct and early diagnosis for LNIPC will show a positive response to Prednisone with or without CsA.Through monitering the levels of B-cell activating factor in patients after transplantation,It may help for early diagnoses and treatment of cGVHD by laboratory instruments.