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Graft-versus-host Disease

Risk factors and organ involvement of chronic GVHD in Japan

Abstract

Few studies have evaluated the risk factors for chronic GVHD and organ involvement associated with different graft types, including unrelated cord blood (U-CB). We retrospectively studied 4818 adult patients who received their first allogeneic transplantation and survived for at least 100 days. The incidence of chronic GVHD at 2 years was 37%. The following factors were associated with the development of chronic GVHD: female donor/male recipient, CMV-Ab seropositivity, matched related peripheral blood grafts vs matched related BM grafts, no in vivo T-cell depletion and the occurrence of grade II–IV acute GVHD. Among these factors, the association with acute GVHD occurrence was consistently significant across donor subtypes. The use of U-CB was not associated with chronic GVHD, but was associated with a low incidence of extensive chronic GVHD. Chronic GVHD patients who had received U-CB transplants showed less frequent involvement of the oral cavity (28% vs 55%), eye (12% vs 26%), liver (20% vs 44%), lung (11% vs 25%) and joint (0% vs 6%) than those with matched related BM grafts. In conclusion, we found that U-CB transplants were associated with a low incidence of extensive chronic GVHD and less frequent involvement of the oral cavity, eye, liver, lung and joints.

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Acknowledgements

We thank all the physicians and data managers at the centers who contributed valuable data on transplantation to the Japan Society for Hematopoietic Cell Transplantation (JSHCT), the Japan Marrow Donor Program (JMDP), the Japan Cord Blood Bank Network (JCBBN) and TRUMP. We also thank the members of the Data Management Committees of JSHCT, JMDP, JCBBN and TRUMP for their assistance. This work was supported in part by SENSHIN Medical Research Foundation (JK).

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Correspondence to J Kanda.

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Kanda, J., Nakasone, H., Atsuta, Y. et al. Risk factors and organ involvement of chronic GVHD in Japan. Bone Marrow Transplant 49, 228–235 (2014). https://doi.org/10.1038/bmt.2013.151

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