SEARCH:   Advanced

Prepublished online as a Blood First Edition Paper on March 27, 2003; DOI 10.1182/blood-2002-08-2628. This Article Full Text (PDF) All Versions of this Article: 2002-08-2628v1 102/2/756    most recent Alert me when this article is cited Alert me if a correction is posted 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 Mielcarek, M. Articles by Storb, R. Search for Related Content PubMed PubMed Citation Articles by Mielcarek, M. Articles by Storb, R. Social Bookmarking                   What's this? Submitted August 28, 2002 Accepted March 21, 2003 Graft-versus-host disease after nonmyeloablative versus conventional hematopoietic stem cell transplantation Marco Mielcarek*, Paul J Martin, Wendy Leisenring, Mary E D Flowers, David G Maloney, Brenda M Sandmaier, Michael B Maris, and Rainer Storb Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA Department of Biostatistics, University of Washington, Seattle, WA, USA * Corresponding author; email: mielcar{at}u.washington.edu. It is not known whether severity, timing, or quality of graft-versus-host disease (GVHD) may be different after nonmyeloablative as compared to myeloablative hematopoietic stem cell transplantation (HSCT). Therefore, GVHD incidence, morbidity of skin, liver and gut, requirements for immunosuppressive therapy, and survival were retrospectively analyzed in 44 nonablative and 52 ablative HSCT recipients (median ages 56 and 54 years, respectively). The nonablative transplant regimen consisted of low-dose total body irradiation (TBI) preceded in some patients by fludarabine and followed by postgrafting immunosuppression with mycophenolate mofetil (MMF) and cyclosporine (CSP). Myeloablative HSCT recipients were prepared with different TBI and non-TBI-containing regimens, and received CSP plus methotrexate or MMF for GVHD prophylaxis. The cumulative incidence of grades II-IV acute GVHD was lower in nonablative transplants (64% vs. 85%, P=.001), but there were no differences in the cumulative incidence of chronic GVHD requiring treatment (73% vs. 71%, P=.96). Nonablative transplantation was associated with delayed initiation of steroid treatment for GVHD (0.95 months vs. 3.0 months, P<.001) and with use of fewer systemic immunosuppressants during the first 3 months after transplant (P.04). This corresponded to more prevalent skin and more severe gut morbidity 6-12 months after nonablative transplantation. Our results show that nonablative HSCT is associated with a syndrome of acute GVHD occurring beyond day 100 in many patients. This "late-onset acute GVHD" should be taken into consideration in the design of prospective studies comparing GVHD between the two types of transplant. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: G. Socie and B. R. Blazar Acute graft-versus-host disease: from the bench to the bedside Blood, November 12, 2009; 114(20): 4327 - 4336. [Abstract] [Full Text] [PDF] H. E. Kohrt, B. B. Turnbull, K. Heydari, J. A. Shizuru, G. G. Laport, D. B. Miklos, L. J. Johnston, S. Arai, W.-K. Weng, R. T. Hoppe, et al. TLI and ATG conditioning with low risk of graft-versus-host disease retains antitumor reactions after allogeneic hematopoietic cell transplantation from related and unrelated donors Blood, July 30, 2009; 114(5): 1099 - 1109. [Abstract] [Full Text] [PDF] E. M. Dunbar, M. P. Buzzeo, J. B. Levine, J. D. Schold, H.-U. Meier-Kriesche, and V. Reddy The relationship between circulating natural killer cells after reduced intensity conditioning hematopoietic stem cell transplantation and relapse-free survival and graft-versus-host disease Haematologica, December 1, 2008; 93(12): 1852 - 1858. [Abstract] [Full Text] [PDF] C. Chang, B. E. Storer, B. L. Scott, E. M. Bryant, H. M. Shulman, M. E. Flowers, B. M. Sandmaier, R. P. Witherspoon, R. A. Nash, J. E. Sanders, et al. Hematopoietic cell transplantation in patients with myelodysplastic syndrome or acute myeloid leukemia arising from myelodysplastic syndrome: similar outcomes in patients with de novo disease and disease following prior therapy or antecedent hematologic disorders Blood, August 15, 2007; 110(4): 1379 - 1387. [Abstract] [Full Text] [PDF] H. J. Deeg How I treat refractory acute GVHD Blood, May 15, 2007; 109(10): 4119 - 4126. [Abstract] [Full Text] [PDF] C. Crawley, S. Iacobelli, B. Bjorkstrand, J. F. Apperley, D. Niederwieser, G. Gahrton, and for the Chronic Leukaemia Working Party of the Eur Reduced-intensity conditioning for myeloma: lower nonrelapse mortality but higher relapse rates compared with myeloablative conditioning Blood, April 15, 2007; 109(8): 3588 - 3594. [Abstract] [Full Text] [PDF] R. M. Saliba, M. de Lima, S. Giralt, B. Andersson, I. F. Khouri, C. Hosing, S. Ghosh, J. Neumann, Y. Hsu, J. De Jesus, et al. Hyperacute GVHD: risk factors, outcomes, and clinical implications Blood, April 1, 2007; 109(7): 2751 - 2758. [Abstract] [Full Text] [PDF] D. Weisdorf GVHD The Nuts and Bolts Hematology, January 1, 2007; 2007(1): 62 - 67. [Abstract] [Full Text] [PDF] M. Bogunovic, F. Ginhoux, A. Wagers, M. Loubeau, L. M. Isola, L. Lubrano, V. Najfeld, R. G. Phelps, C. Grosskreutz, E. Scigliano, et al. Identification of a radio-resistant and cycling dermal dendritic cell population in mice and men J. Exp. Med., November 27, 2006; 203(12): 2627 - 2638. [Abstract] [Full Text] [PDF] S. O. Schonland, H. Lokhorst, A. Buzyn, V. Leblond, U. Hegenbart, G. Bandini, A. Campbell, E. Carreras, A. Ferrant, L. Grommisch, et al. Allogeneic and syngeneic hematopoietic cell transplantation in patients with amyloid light-chain amyloidosis: a report from the European Group for Blood and Marrow Transplantation Blood, March 15, 2006; 107(6): 2578 - 2584. [Abstract] [Full Text] [PDF] E. Waldman, S. X. Lu, V. M. Hubbard, A. A. Kochman, J. M. Eng, T. H. Terwey, S. J. Muriglan, T. D. Kim, G. Heller, G. F. Murphy, et al. Absence of beta7 integrin results in less graft-versus-host disease because of decreased homing of alloreactive T cells to intestine Blood, February 15, 2006; 107(4): 1703 - 1711. [Abstract] [Full Text] [PDF] M. P. Collin, D. N.J. Hart, G. H. Jackson, G. Cook, J. Cavet, S. Mackinnon, P. G. Middleton, and A. M. Dickinson The fate of human Langerhans cells in hematopoietic stem cell transplantation J. Exp. Med., January 23, 2006; 203(1): 27 - 33. [Abstract] [Full Text] [PDF] U. Hegenbart, D. Niederwieser, B. M. Sandmaier, M. B. Maris, J. A. Shizuru, H. Greinix, C. Cordonnier, B. Rio, A. Gratwohl, T. Lange, et al. Treatment for Acute Myelogenous Leukemia by Low-Dose, Total-Body, Irradiation-Based Conditioning and Hematopoietic Cell Transplantation From Related and Unrelated Donors J. Clin. Oncol., January 20, 2006; 24(3): 444 - 453. [Abstract] [Full Text] [PDF] B. L. Scott and B. M. Sandmaier Outcomes with Myeloid Malignancies Hematology, January 1, 2006; 2006(1): 381 - 389. [Abstract] [Full Text] [PDF] M. Mohty, D. Blaise, C. Faucher, N. Vey, R. Bouabdallah, A.-M. Stoppa, F. Viret, G. Gravis, D. Olive, and B. Gaugler Inflammatory cytokines and acute graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation Blood, December 15, 2005; 106(13): 4407 - 4411. [Abstract] [Full Text] [PDF] C. Crawley, R. Szydlo, M. Lalancette, A. Bacigalupo, A. Lange, M. Brune, G. Juliusson, A. Nagler, A. Gratwohl, J. Passweg, et al. Outcomes of reduced-intensity transplantation for chronic myeloid leukemia: an analysis of prognostic factors from the Chronic Leukemia Working Party of the EBMT Blood, November 1, 2005; 106(9): 2969 - 2976. [Abstract] [Full Text] [PDF] R. Lowsky, T. Takahashi, Y. P. Liu, S. Dejbakhsh-Jones, F. C. Grumet, J. A. Shizuru, G. G. Laport, K. E. Stockerl-Goldstein, L. J. Johnston, R. T. Hoppe, et al. Protective conditioning for acute graft-versus-host disease. N. Engl. J. Med., September 29, 2005; 353(13): 1321 - 1331. [Abstract] [Full Text] [PDF] G. Socié Graft-versus-host disease--from the bench to the bedside? N. Engl. J. Med., September 29, 2005; 353(13): 1396 - 1397. [Full Text] [PDF] A. C. Lipkin, P. Lenssen, and B. J. Dickson Nutrition Issues in Hematopoietic Stem Cell Transplantation: State of the Art Nutr Clin Pract, August 1, 2005; 20(4): 423 - 439. [Abstract] [Full Text] [PDF] C. Crawley, M. Lalancette, R. Szydlo, M. Gilleece, K. Peggs, S. Mackinnon, G. Juliusson, L. Ahlberg, A. Nagler, A. Shimoni, et al. Outcomes for reduced-intensity allogeneic transplantation for multiple myeloma: an analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT Blood, June 1, 2005; 105(11): 4532 - 4539. [Abstract] [Full Text] [PDF] F. Baron, M. B. Maris, B. M. Sandmaier, B. E. Storer, M. Sorror, R. Diaconescu, A. E. Woolfrey, T. R. Chauncey, M. E.D. Flowers, M. Mielcarek, et al. Graft-Versus-Tumor Effects After Allogeneic Hematopoietic Cell Transplantation With Nonmyeloablative Conditioning J. Clin. Oncol., March 20, 2005; 23(9): 1993 - 2003. [Abstract] [Full Text] [PDF] M. Sorror, M. Maris, R. Diaconescu, and R. Storb Lessened severe graft-versus-host after "minitransplantations" Blood, March 15, 2005; 105(6): 2614 - 2614. [Full Text] [PDF] T. M. Cao, J. A. Shizuru, R. M. Wong, K. Sheehan, G. G. Laport, K. E. Stockerl-Goldstein, L. J. Johnston, M. J. Stuart, F. C. Grumet, R. S. Negrin, et al. Engraftment and survival following reduced-intensity allogeneic peripheral blood hematopoietic cell transplantation is affected by CD8+ T-cell dose Blood, March 15, 2005; 105(6): 2300 - 2306. [Abstract] [Full Text] [PDF] E. P. Alyea, H. T. Kim, V. Ho, C. Cutler, J. Gribben, D. J. DeAngelo, S. J. Lee, S. Windawi, J. Ritz, R. M. Stone, et al. Comparative outcome of nonmyeloablative and myeloablative allogeneic hematopoietic cell transplantation for patients older than 50 years of age Blood, February 15, 2005; 105(4): 1810 - 1814. [Abstract] [Full Text] [PDF] M. Kami, A. Makimoto, Y. Heike, and Y. Takaue Reduced-intensity Hematopoietic Stem Cell Transplantation (RIST) for Solid Malignancies Jpn. J. Clin. Oncol., December 1, 2004; 34(12): 707 - 716. [Abstract] [Full Text] [PDF] S. S. Tykodi, E. H. Warren, J. A. Thompson, S. R. Riddell, R. W. Childs, B. E. Otterud, M. F. Leppert, R. Storb, and B. M. Sandmaier Allogeneic Hematopoietic Cell Transplantation for Metastatic Renal Cell Carcinoma after Nonmyeloablative Conditioning: Toxicity, Clinical Response, and Immunological Response to Minor Histocompatibility Antigens Clin. Cancer Res., December 1, 2004; 10(23): 7799 - 7811. [Abstract] [Full Text] [PDF] M. P. Rettig, J. K. Ritchey, J. L. Prior, J. S. Haug, D. Piwnica-Worms, and J. F. DiPersio Kinetics of In Vivo Elimination of Suicide Gene-Expressing T Cells Affects Engraftment, Graft-versus-Host Disease, and Graft-versus-Leukemia after Allogeneic Bone Marrow Transplantation J. Immunol., September 15, 2004; 173(6): 3620 - 3630. [Abstract] [Full Text] [PDF] R. Diaconescu, C. R. Flowers, B. Storer, M. L. Sorror, M. B. Maris, D. G. Maloney, B. M. Sandmaier, and R. Storb Morbidity and mortality with nonmyeloablative compared with myeloablative conditioning before hematopoietic cell transplantation from HLA-matched related donors Blood, September 1, 2004; 104(5): 1550 - 1558. [Abstract] [Full Text] [PDF] B. E. Anderson, J. M. McNiff, C. Matte, I. Athanasiadis, W. D. Shlomchik, and M. J. Shlomchik Recipient CD4+ T cells that survive irradiation regulate chronic graft-versus-host disease Blood, September 1, 2004; 104(5): 1565 - 1573. [Abstract] [Full Text] [PDF] C. R. Parikh, B. M. Sandmaier, R. F. Storb, K. G. Blume, F. Sahebi, D. G. Maloney, M. B. Maris, Y. Nieto, C. L. Edelstein, R. W. Schrier, et al. Acute Renal Failure after Nonmyeloablative Hematopoietic Cell Transplantation J. Am. Soc. Nephrol., July 1, 2004; 15(7): 1868 - 1876. [Abstract] [Full Text] [PDF] S. Miyakoshi, K. Yuji, M. Kami, E. Kusumi, Y. Kishi, K. Kobayashi, N. Murashige, T. Hamaki, S.-W. Kim, J.-i. Ueyama, et al. Successful Engraftment After Reduced-Intensity Umbilical Cord Blood Transplantation for Adult Patients with Advanced Hematological Diseases Clin. Cancer Res., June 1, 2004; 10(11): 3586 - 3592. [Abstract] [Full Text] [PDF] U. Schuler Reduced intensity conditioning before allografting: moderate enthusiasm may be more appropriate Eur. Respir. J., March 1, 2004; 23(3): 357 - 358. [Full Text] [PDF] E. Holler Early gastrointestinal GvHD: apoptosis but no donor repair? Blood, January 1, 2004; 103(1): 4 - 4. [Full Text] [PDF] S. S. B. Randolph, T. A. Gooley, E. H. Warren, F. R. Appelbaum, and S. R. Riddell Female donors contribute to a selective graft-versus-leukemia effect in male recipients of HLA-matched, related hematopoietic stem cell transplants Blood, January 1, 2004; 103(1): 347 - 352. [Abstract] [Full Text] [PDF]

	Copyright © 2003 by American Society of Hematology         Online ISSN: 1528-0020