[Clinical characteristics of acute graft-versus-host disease among different donors of allogeneic hematopoietic stem cell transplantation].

OBJECTIVE

To analyze the characteristics and the number of organs involved in acute graft-versus-host disease (aGVHD) among different donors of allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODS

Clinical data were retrospectively analyzed in 289 patients received allo-HSCT in our hospital, between November 2007 and December 2008. Clinical features of the involved organs between different donors were compared.

RESULTS

The cumulative incidence of aGVHD was 57.4% (166/289), grades I-II and grades III-IV were 52.1% and 11.0%, respectively. Skin was involved in 116 (69.9%) of the total 166 cases, gut 97 (47.6%), and liver 25(15.1%). Organs involved in HLA-identical sibling transplantation and in haplo-identical ones were skin 19 (42.2%), gut 25 (55.6%), and liver 12 (26.7%), and 79 (80.2%), 54 (44.6%) and 13 (10.7%) respectively. More aGVHD involvements of skin were found in HLA haplo-identical HSCT than in HLA identical sibling HSCT (P = 0.000). The involvement of skin grade II was 8(17.8%) and 38.8% (P = 0.01), gut grade II was 22 (48.9%) and 36 (29.8%) (P = 0.028) in HLA identical sibling transplantation and in haploidentical HSCT, repectively. The incidences of aGVHD grades I to II and grade III to IV were 103 (62.0%) versus 12 (7.2%) in the single organ involved group, 37 (22.3%) versus 11 (6.6%) in the double organs involved group, and 0% versus 3 (1.8%) in the triple organs involved group.

CONCLUSION

The percentage of aGVHD with skin involvement in haploidentical HSCT is significantly higher than that in HLA identical HSCT. There is a significant difference in mild skin or GI aGVHD between HLA matched and mismatched HSCT, but no difference in severe skin or GI aGVHD between the two groups. The percentage of severe aGVHD was higher if three organs were involved.