Chronic Graft-Versus Host Disease - Single Center Experience
Journal Title: Macedonian Journal of Medical Sciences (MJMS) - Year 2008, Vol 1, Issue 1
Abstract
Background. With the increasing number of patients surviving peritransplant complications of stem-cell transplantation (SCT), the incidence of chronic Graft Versus Host Disease (cGVHD) has increased too. cGVHD now develops in approximately 30-50% of patients undergoing SCT. Risk factors associated with the development of cGVHD are: previous acuteGVHD (aGVHD), prior cytomegalovirus infection, use of a matched unrelated donor and combination of a male recipient with a female donor. Not all patients who develop aGVHD progress to cGVHD. The latter may occur de novo. Aim. To describe clinical and patohistological findings and influence of cGVHD on survival in allogeneic stem cell recipients. Material and methods. During 7 years period we have treated 40 patients with allogeneic SCT from HLA identical sibling. aGVHD prophylaxis comprised Seattle protocol. Results. 12 patients (6 males, 6 females; mean age: 34,5) developed cGVHD (7 de novo). Distribution according to diagnosis: Acute Myeloid Leukemia (n=8), Chronic Myeloid Leukemia (n=3), Primary myelofibrosis (n=1). Six of them had limited disease, and 6 had extensive. Treatment comprised: corticosteroids + CsA (6), Mophetyl mycophenolate (4), Tacrolimus (2), Photochemiotherapy (3). 10 (83%) patients are alive; 2 (17%) died. Conclusion. Despite advances in histocompatibility matching and immunosuppressive drugs, GVHD has continued to be a common and often lethal complication of SCT.
Authors and Affiliations
Zlate Stojanoski| Hematology Clinic, Medical Faculty, University “Ss Kiril and Metodij”, Skopje, Republic of Macedonia, Svetlana Krstevska-Balkanov| Institute for Pathology, Medical Faculty, University “Ss Kiril and Metodij”, Skopje, Republic of Macedonia, Georgi Gocev| Dermatology Clinic, Medical Faculty, University “Ss Kiril and Metodij”, Skopje, Republic of Macedonia, Sonja GenadievaStavrik| Hematology Clinic, Medical Faculty, University “Ss Kiril and Metodij”, Skopje, Republic of Macedonia, Lidija Cevreska| Hematology Clinic, Medical Faculty, University “Ss Kiril and Metodij”, Skopje, Republic of Macedonia, Borche Georgievski| Hematology Clinic, Medical Faculty, University “Ss Kiril and Metodij”, Skopje, Republic of Macedonia
Keywords
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- EP ID EP8584
- DOI 10.3889/MJMS.1857-5773.2008.0006
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