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Blood, 1 December 2004, Vol. 104, No. 12, pp. 3501-3506. Prepublished online as a Blood First Edition Paper on August 3, 2004; DOI 10.1182/blood-2004-01-0200. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-01-0200v1 104/12/3501    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Stewart, B. L. Articles by Martin, P. J. Search for Related Content PubMed PubMed Citation Articles by Stewart, B. L. Articles by Martin, P. J. Related Collections Immunobiology Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Duration of immunosuppressive treatment for chronic graft-versus-host disease Betty L. Stewart, Barry Storer, Jan Storek, H. Joachim Deeg, Rainer Storb, John A. Hansen, Frederick R. Appelbaum, Paul A. Carpenter, Jean E. Sanders, Hans-Peter Kiem, Richard A. Nash, Effie W. Petersdorf, Carina Moravec, A. James Morton, Claudio Anasetti, Mary E. D. Flowers, and Paul J. Martin From the Division of Clinical Research, Fred Hutchinson Cancer Research Center and the Departments of Medicine and Pediatrics, University of Washington, Seattle, WA; and Wesley Haematology and Oncology Clinics of Australasia, Auchenflower, Australia. Chronic graft-versus-host disease (GVHD) requires long-term immunosuppressive therapy after hematopoietic cell transplantation. We retrospectively analyzed a cohort of 751 patients with chronic GVHD to identify characteristics associated with the duration of immunosuppressive treatment. Among the 274 patients who discontinued immunosuppressive therapy after resolution of chronic GVHD before recurrent malignancy or death, the median duration of treatment was 23 months. Results of a multivariable model showed that treatment was prolonged in patients who received peripheral blood cells, in male patients with female donors, in those with graft-versus-host HLA mismatching, and in those with hyperbilirubinemia or multiple sites affected by chronic GHVD at the onset of the disease. Nonrelapse mortality was increased among patients with HLA mismatching or hyperbilirubinemia but not among those with other risk factors associated with prolonged treatment for chronic GVHD. Nonrelapse mortality was also increased in older patients and those with older donors, in patients with platelet counts less than 100 000/µL or progressive onset of chronic GVHD from acute GVHD, and in those receiving higher doses of prednisone immediately before the diagnosis of chronic GVHD. After the dose of prednisone was taken into account, progressive onset was not associated with an increased risk of nonrelapse mortality. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: D. A. Jacobsohn, A. L. Gilman, A. Rademaker, B. Browning, M. Grimley, L. Lehmann, E. R. Nemecek, K. Thormann, K. R. Schultz, and G. B. Vogelsang Evaluation of pentostatin in corticosteroid-refractory chronic graft-versus-host disease in children: a Pediatric Blood and Marrow Transplant Consortium study Blood, November 12, 2009; 114(20): 4354 - 4360. [Abstract] [Full Text] [PDF] A. C. Vigorito, P. V. Campregher, B. E. Storer, P. A. 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