A Clinical Study Of Graft-Versus-Host Diseasc After Allogeneic Hemapoietic Stem Cell Transplantation In 185 Patients

Objective:To investigate the incidence and risk factors of graft-versus-host disease(GVHD) after allogeneic hemapoietic stem cell transplantation (allo-HSCT).Methods: The total study population was 185 patients receiving a myeloablative allogeneic peripheral blood stem cell transplantation in our centers between 2001 and 2010. OF these patients,123 were male and 62 were female, with a median age of 35(2～57) years.166 patients were Hematologic Malignancies,19 patients were no of Hematologic Malignancies. OF these patients,85 were the same sex of donor and recipient,41 were Male donor and female recipient,59 were female donor and male recipient.116 patiens were ABO-compatible,69 patiens were ABO-imcompatible. 60 patiens received a conditioning regimen based on total body irradiation and cyclophosphamide,121 were received a conditioning regimen based on busulfan and CY,4 were received different of conditioning regimens .161 patiens were received PBSCT,24 patiens were received PBSCT+BMT.A combination of cyclosporine and short course of methotrexate and mycophenolate mofetil was administered for graft-versus-host disease prophylaxis. With a median follow up of 55(3～110)months.Results:1.The incidence of aGVHD was 16.2%,gradesⅠ6.5% ,gradesⅡ～Ⅳ6%,gradesⅢ～Ⅳ4.3%. 2.The incidence of cGVHD was 37.1%, extensive cGVHD occurred in 34(20%), limited cGVHD occurred in 29(17.1%).3.The univariate analysis showed that patiens age and CD34~+ cell number dose were significant risk factors for aGVHD.Diagnosis,methods of transplantation, methods of preconditioning ,sex of donor and recipient, whether once occuredⅡ～ⅣaGVHD were closely associated with the occurance of cGVHD.4.On the COX regression model,2 independent factors for aGVHD were patiens age and CD34~+ cell number.Female donor to male patiens and once occuredⅡ～ⅣaGVHD were cGVHD high-risk factors.Conclusion: The combination of CsA,MTX,low dose and short course of MMF in Allo-HSCT can decrease the risk for aGVHD.The Older patiens age were or the more CD34~+ cell number inputed ,the risk of aGVHD was highter.Female donor to male recipients and once occuredⅡ～ⅣaGVHD were cGVHD high-risk factor.