Nakane Takahiko, Fukuda Takahiro, Kanda Junya, Taniguchi Shuichi, Eto Tetsuya, Ohashi Kazuteru, Nakamae Hirohisa, Kurokawa Mineo, Mori Takehiko, Morishima Yasuo, Nagamura-Inoue Tokiko, Sakamaki Hisashi, Atsuta Yoshiko, Murata Makoto
a Hematology, Graduate School of Medicine, Osaka City University , Osaka , Japan.
b GVHD working group of the Japan Society for Hematopoietic Cell Transplantation.
Leuk Lymphoma. 2015;56(8):2392-7. doi: 10.3109/10428194.2015.1009056. Epub 2015 Feb 9.
We retrospectively analyzed 2682 patients who developed grade II-IV acute graft-versus-host disease (GVHD). On analysis with stratification into five age groups (20-29, 30-39, 40-49, 50-59 and ≥60), 2-year non-relapse mortality rates (NRM) after the onset of GVHD were 20.7, 26.2, 26.6, 37.0 and 40.4%, respectively (p<0.001). We found a significant interaction between the patient's age and GVHD severity with respect to NRM (p=0.004). On multivariate analyses stratified by GVHD severity, the hazard ratio (HR) for NRM in the groups aged 50 years or more (reference: age group 20-29) was about twice as great in patients with grade II acute GVHD when compared with grade III-IV disease (HR in those aged 50-59 years: 2.9 for grade II and 1.5 [p=0.03 and 0.04] for grades III-IV; HR if ≥60 years: 3.3 for grade II and 1.5 for grades III-IV [p<0.001 for both]).
我们回顾性分析了2682例发生II-IV级急性移植物抗宿主病（GVHD）的患者。在按五个年龄组（20-29岁、30-39岁、40-49岁、50-59岁和≥60岁）分层分析时，GVHD发病后2年的无复发生存率（NRM）分别为20.7%、26.2%、26.6%、37.0%和40.4%（p<0.001）。我们发现患者年龄与GVHD严重程度在NRM方面存在显著交互作用（p=0.004）。在按GVHD严重程度分层的多因素分析中，50岁及以上组（参照组：20-29岁年龄组）II级急性GVHD患者的NRM风险比（HR）约为III-IV级疾病患者的两倍（50-59岁患者中，II级为2.9，III-IV级为1.5 [p=0.03和0.04]；≥60岁患者中，II级为3.3，III-IV级为1.5 [两者p均<0.001]）。
