Old Age or First Time Transfusions as a Risk of PT-GVHD.

[Purpose] The Japan Society of Blood Transfusion issued the Guidelines for irradiation of blood and blood components to prevent post-transfusion graft-versus-host disease (PT-GVHD) in Japan (Transfusion Medicine 10: 315320, 2001). In these guidelines, old age and first time transfusions were mentioned as risk factors of PT-GVHD. We show results of the analysis of these risk factors. [Method] Sixty one patients reported to and confirmed with DNA polymorphism at the Japanese Red Cross Central Blood Center were analyzed as patients of PT-GVHD. The age of these patients was compared to 18,878 patients treated with transfusions in November 1998, surveyed through 1,607 hospitals by the Japanese Ministry of Health and Welfare. The patient's history of transfusion was compared to that of 4,148 patients who were treated with transfusions at Chiba University Hospital in 1999. [Results] Old age risk for PT-GVHD: From the 61 patients of PT-GVHD, 50 patients (82%) were over 65 years-old. These are significantly shifted (p <0.01) to old age, compared to the rate of over 65 year-old patients who number 10,204 (54%) out of 18,878 patients treated with transfusions in the 1,607 hospitals in Japan. Risk of first time transfusions: Of the 52 patients with PT-GVHD who were reported with their history of transfusion, 2 patients had histories of transfusions, however 50 patients (95%) had no history of blood transfusion. This rate is significantly high (p <0.01) compared to the 1,766 patients (43%) who had never been transfused, at least one month before the transfusion at our hospital, out of 4,148 patients who had been transfused in our hospital. [Discussion] It is not clear about the mechanism for the tendency to suffer from PT-GVHD with elderly patients and on first time transfusions. However, these differences were statistically significant, therefore should be considered as risk factors for PT-GVHD, as well as other risk factors. [Conclusion] We confirmed old age or first time transfusions as being a risk factor for PT-GVHD. [ABSTRACT FROM AUTHOR]