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Impact of graft-versus-host disease on outcomes after allogeneic hematopoietic cell transplantation for adult T-cell leukemia: a retrospective cohort study
- Source :
- Blood. 119:2141-2148
- Publication Year :
- 2012
- Publisher :
- American Society of Hematology, 2012.
-
Abstract
- Allogeneic hematopoietic cell transplantation (HCT) is an effective treatment for adult T-cell leukemia (ATL), raising the question about the role of graft-versus-leukemia effect against ATL. In this study, we retrospectively analyzed the effects of acute and chronic graft-versus-host disease (GVHD) on overall survival, disease-associated mortality, and treatment-related mortality among 294 ATL patients who received allogeneic HCT and survived at least 30 days posttransplant with sustained engraftment. Multivariate analyses treating the occurrence of GVHD as a time-varying covariate demonstrated that the development of grade 1-2 acute GVHD was significantly associated with higher overall survival (hazard ratio [HR] for death, 0.65; P = .018) compared with the absence of acute GVHD. Occurrence of either grade 1-2 or grade 3-4 acute GVHD was associated with lower disease-associated mortality compared with the absence of acute GVHD, whereas grade 3-4 acute GVHD was associated with a higher risk for treatment-related mortality (HR, 3.50; P < .001). The development of extensive chronic GVHD was associated with higher treatment-related mortality (HR, 2.75; P = .006) compared with the absence of chronic GVHD. Collectively, these results indicate that the development of mild-to-moderate acute GVHD confers a lower risk of disease progression and a beneficial influence on survival of allografted patients with ATL.
- Subjects :
- Adult
Male
Oncology
medicine.medical_specialty
Transplantation Conditioning
Immunology
T-cell leukemia
Graft vs Host Disease
Disease
Lower risk
Biochemistry
Cohort Studies
Young Adult
immune system diseases
Internal medicine
medicine
Humans
Leukemia-Lymphoma, Adult T-Cell
Transplantation, Homologous
Aged
Retrospective Studies
business.industry
Hazard ratio
Hematopoietic Stem Cell Transplantation
Retrospective cohort study
Cell Biology
Hematology
Middle Aged
medicine.disease
Survival Analysis
Transplantation
Leukemia
Treatment Outcome
surgical procedures, operative
Graft-versus-host disease
Female
business
Subjects
Details
- ISSN :
- 15280020 and 00064971
- Volume :
- 119
- Database :
- OpenAIRE
- Journal :
- Blood
- Accession number :
- edsair.doi.dedup.....a3344c696862ddbf26b31fee239aee2d