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Age, Conditioning Regimen Significant Predictors of Graft-Versus-Host Disease: Presented at AACR

By Charlene Laino

WASHINGTON, D.C. -- April 7, 2006 -- Although the incidence of overall Grade 2-4 acute graft-versus-host disease (aGVHD) after allogeneic bone marrow transplantation (BMT) has not changed over time, the risk factors for this outcome have changed, a retrospective study shows.

By 1999 to 2002, only age and conditioning regimen remained significant predictors of acute graft-versus-host disease, reported Theresa Hahn, PhD, assistant member, Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York, United States.

Dr. Hahn presented the findings of a study that retrospectively analyzed risk factors for aGVHD in patients who received human leukocyte antigen (HLA)-matched allogeneic BMT at the 97^th Annual Meeting of the American Association for Cancer Research (AACR).

Determination of pre-BMT risk factors for aGVHD may help to identify high-risk patients who may benefit from more intensive immunosuppression before the procedure, Dr. Hahn said at a press conference on April 3^rd.

The researchers analyzed risk factors for acute graft-versus-host disease in 2416 patients who underwent HLA-matched BMT from 1995 to 2002 for the following conditions: 934 patients for acute myeloid leukemia, 542 for acute lymphatic leukemia, and 940 for chronic myeloid leukemia.

All of the patients received cyclosporine plus methotrexate, with or without other agents, for the prevention of aGVHD.

Of the total, 746 (31%) patients developed Grade 2-4 aGVHD by the 100^th day after BMT.

The study population was then divided into 2 cohorts: 1203 were transplanted between 1995 and 1998 (early) and 1213 were transplanted between 1999 and 2002 (late).

Multivariate analysis showed that in the early time period, risk factors for aGVHD were race, age, type of cancer, disease status, and conditioning regimen. By the late period, age and conditioning regimen alone had predictive value.

Patients age 40 years and older were 2.15 times more likely to develop aGVHD than those under age 20 years (P <.0001). And patients treated with cyclophosphamide plus total body irradiation were at 60% increased risk compared with those who received busulfan plus cyclophosphamide (P =.0002).

The cumulative incidence of aGVHD did not change over time, the study showed.


[Presentation title: Risk Factors for Acute GVHD After Related HLA-Matched Allogeneic Blood or Marrow Transplant. Abstract 2881]

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