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Prepublished online as a Blood First Edition Paper on April 17, 2002; DOI 10.1182/blood-2001-11-0057.
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Blood, 15 July 2002, Vol. 100, No. 2, pp. 724-727
BRIEF REPORT
Risk factors for acute graft-versus-host disease in patients
undergoing transplantation with CD34+ selected blood cells
from HLA-identical siblings
Alvaro Urbano-Ispizua,
Ciril Rozman,
Pedro Pimentel,
Carlos Solano,
Javier de la Rubia,
Salut Brunet,
Jaime Pérez-Oteyza,
Christelle Ferrá,
Javier Zuazu,
Dolores Caballero,
Joan Bargay,
Alzira Carvalhais,
Jose Luis Díez,
Ildefonso Espigado,
Adrián Alegre,
Montserrat Rovira,
Fernando Campilho,
Jesús Odriozola,
Miguel Angel Sanz,
Jordi Sierra,
Javier García-Conde, and
Emili Montserrat
From the Spanish Group for Allogeneic Peripheral Blood
Transplantation (Grupo Español de Trasplante Hemopoyético)
and Instituto Português de Oncologia Porto. Participating
centers are listed in the appendix at the end of this
article.
A study on 315 patients undergoing transplantation with
CD34+ selected blood cells from HLA-identical siblings was
performed to determine risk factors for acute GVHD (aGVHD). Recipients
of a dose of CD34+ cells (× 106/kg) of 2 or
less, more than 2 to 4, and more than 4 had a cumulative incidence of
aGVHD grades I-IV of 21%, 35%, and 43%, respectively (log-rank
P = .01); similarly, recipients of a dose of
CD3+ cells (× 106/kg) of 0.05 or less, more
than 0.05 to 0.1, and more than 0.1 had a cumulative incidence of aGVHD
grades I-IV of 18%, 35%, and 44%, respectively (log-rank
P = .007). Using a Cox regression model, 4 independent
factors for aGVHD I-IV were identified: increased CD34+
cell dose (P = .02), increased CD3+ cell dose
(P = .02), female patients (P = .01), and
higher patient age (> 42 years) (P = .007). This study
shows, for the first time in T-cell-depleted transplantations, a
positive correlation between the number of CD34+ cells and
aGVHD and, also, that the number of CD3+ cells necessary to
initiate aGVHD is lower than previously reported.
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