RAINER STORB, M.D.; ROSS L. PRENTICE, Ph.D.; KEITH M. SULLIVAN, M.D.; HOWARD M. SHULMAN, M.D.; H. JOACHIM DEEG, M.D.; KRISTINE C. DONEY, M.D.; C. DEAN BUCKNER, M.D.; REGINALD A. CLIFT, F.I.M.L.S.; ROBERT P. WITHERSPOON, M.D.; FREDERICK A. APPELBAUM, M.D.; JEAN E. SANDERS, M.D.; PATRICIA S. STEWART, M.D.; E. DONNALL THOMAS, M.D.
One hundred ten of 175 patients with aplastic anemia conditioned by cyclophosphamide had sustained engraftment of marrow from human leukocyte antigen (HLA)-identical siblings and lived for more than 6 months. Forty-nine of the 110 patients developed chronic graft-versus-host disease between 85 and 464 days. Ninety-seven patients are alive from 1.4 to 11 years after engraftment; 13 died between 208 and 726 days. Twenty of the 36 surviving patients with chronic graft-versus-host disease have Karnofsky performance scores of 100%, 7 of 90%, 5 of 80%, 1 of 70%, 2 of 60%, and 1 of 40%. Our analysis, using a binary logistic regression model, identified three factors predicting chronic graft-versus-host disease: moderate to severe acute graft-versus-host disease with an estimated relative risk of 11.65; increasing patient age; and the use of viable donor buffy coat cells in addition to the marrow to prevent graft rejection. The last two factors were significant only in patients without acute graft-versus-host disease.
STORB R, PRENTICE RL, SULLIVAN KM, SHULMAN HM, DEEG HJ, DONEY KC, et al. Predictive Factors in Chronic Graft-Versus-Host Disease in Patients with Aplastic Anemia Treated by Marrow Transplantation from HLA-Identical Siblings. Ann Intern Med. ;98:461–466. doi: 10.7326/0003-4819-98-4-461
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Published: Ann Intern Med. 1983;98(4):461-466.
Hematology/Oncology, Red Cell Disorders.
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