Repository of Research and Investigative Information

Repository of Research and Investigative Information

Ilam University of Medical Sciences

Effects of aGVHD and cGVHD according to relapse status on survival rate in patients with acute lymphocytic leukemia

Wed Jul 24 16:56:50 2024

(2014) Effects of aGVHD and cGVHD according to relapse status on survival rate in patients with acute lymphocytic leukemia. Hematology. pp. 441-447. ISSN 1024-5332

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Objectives: Graft-versus-host disease (GVHD) is an exaggerated and dysregulated response of the normal immune system to tissue damage that is intrinsic to transplantation. The aim of this study was to assess the effects of acute GVHD (aGVHD) and chronic GVHD (cGVHD) according to relapse status on the survival rate in patients with acute lymphocytic leukemia (ALL). Methods: Patients with ALL (n = 425) between 1991 and 2011, who underwent bone marrow transplantation and stem cell transplantation in Tehran (Iran), were recruited into a longitudinal study. All patient records were screened for the occurrence of adverse events including GVHD and relapse. Data were assessed using SPSS software with log-rank, univariate, and multivariate Cox regression analyses. Results: Five-year survival rate based on a Kaplan-Meier curve was 60.2 overall (95 confidence interval (CI): 54.32-66.08) and 66.6 (95 CI: 59.35-73.86) for individuals in their first complete remission (CR1) disease stage. A significantly higher survival rate was observed for patients who developed cGVHD in comparison with those who did not develop it, with a 2.7 fold increased risk of mortality for the latter group (P < 0.001). A significant Cox proportional hazard ratio of 2.3 was observed for mortality following adjustments for age and gender. The presence of cGVHD, reduced the risk of mortality for all individuals, which was observed to be significant for those patients without relapse (P = 0.004). Conclusion: This study is one of the largest studies (regarding the number of participants) done to date in the Middle East with quite a long duration (20 years). Findings suggest that cGVHD has a positive influence on the survival rates for ALL patients, which subsequently may assist physicians to make optimal treatment decisions. Additional research is now needed to determine the mechanisms around this increased survival and its influence on patients' survival.

Item Type: Article
Alimoghadam, K.UNSPECIFIED
Keywords: Acute lymphocytic leukemia cGVHD aGVHD HSCT Survival rate versus-host-disease acute lymphoblastic-leukemia bone-marrow-transplantation cell transplantation prognostic-factors complete remission elderly-patients single-center children criteria Hematology
Page Range: pp. 441-447
Journal or Publication Title: Hematology
Journal Index: ISI
Volume: 19
Number: 8
Identification Number:
ISSN: 1024-5332
Depositing User: مهندس مهدی شریفی

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