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High incidence of thromboembolism in patients with chronic GVHD: association with severity of GVHD and donor-recipient ABO blood group.
- Source :
-
Blood cancer journal [Blood Cancer J] 2021 May 18; Vol. 11 (5), pp. 96. Date of Electronic Publication: 2021 May 18. - Publication Year :
- 2021
-
Abstract
- Chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation (HCT) is associated with systemic inflammation and endothelial dysfunction, increasing risk for thromboembolic events (TEE). In 145 adult recipients who developed cGVHD after a matched sibling or umbilical cord blood donor HCT from 2010 to 2018, 32(22%) developed at least 1 TEE event, and 14(10%) developed 2 TEE events. The 5-year cumulative incidence of TEE was 22% (95% CI, 15-29%) with a median time from cGVHD to TEE of 234 days (range, 12-2050). Median time to the development of LE DVT or PE was 107 (range, 12-1925) compared to 450 days (range, 158-1300) for UE DVT. Cumulative incidence of TEE was 9% (95% CI, 0-20%), 17% (95% CI, 9-25%), and 38% (95% CI, 22-55%) in those with mild, moderate, and severe GVHD, respectively. Higher risk for TEE was associated with cGVHD severity (hazard ratio [HR] 4.9, [95% CI, 1.1-22.0]; p = 0.03), non-O-donor to recipient ABO match compared to O-donor to O-recipient match (HR 2.7, [95% CI, 1.0-7.5]; p = 0.053), and personal history of coronary artery disease (HR 2.4, [95% CI, 1.1-5.3]; p = 0.03). TEE was not associated with 2-year non-relapse mortality or 5-year overall survival.
- Subjects :
- Adult
Aged
Chronic Disease
Female
Graft vs Host Disease etiology
Hematopoietic Stem Cell Transplantation adverse effects
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Risk Factors
Severity of Illness Index
Tissue Donors
Transplantation, Homologous adverse effects
Young Adult
ABO Blood-Group System analysis
Graft vs Host Disease complications
Thromboembolism etiology
Subjects
Details
- Language :
- English
- ISSN :
- 2044-5385
- Volume :
- 11
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Blood cancer journal
- Publication Type :
- Academic Journal
- Accession number :
- 34006823
- Full Text :
- https://doi.org/10.1038/s41408-021-00488-2