Ringdén O, Paulin T, Lönnqvist B, Nilsson B
Exp Hematol. 1985 Nov;13(10):1062-7.
Among 75 consecutive allogeneic bone marrow transplant recipients, 24 developed chronic graft-versus-host disease (GVHD), which was diagnosed from day 31 to day 368 after transplantation. Eight (33%) patients had more extensive chronic GVHD, and five patients died. The actuarial incidence of chronic GVHD was 48% at 400 days. A number of factors were analyzed for their association with chronic GVHD. Recipients of marrow from donors over 17 years of age had an actuarial incidence of chronic GVHD at 400 days of 74%, compared with 27% if the donors were under 17 years of age (log-rank test on survival curves, p less than 0.001). Other factors that appeared to predispose for chronic GVHD in bivariate analysis were recipient age above 17 years (p less than 0.02), treatment with donor unirradiated buffy-coat cells (p less than 0.01), grade-II-IV acute GVHD (p less than 0.01), and a preceding cytomegalovirus (CMV) infection (p less than 0.01). In multi-variate analysis, however, only donor age above 17 years, treatment with donor buffy-coat cells, and grade-II-IV acute GVHD were significantly associated with chronic GVHD. The possible role of CMV infection in the development of chronic GVHD is discussed.
在75例连续接受异基因骨髓移植的患者中，24例发生了慢性移植物抗宿主病（GVHD），于移植后第31天至第368天确诊。8例（33%）患者的慢性GVHD更为广泛，5例患者死亡。400天时慢性GVHD的精算发病率为48%。分析了若干因素与慢性GVHD的相关性。17岁以上供者骨髓的受者在400天时慢性GVHD的精算发病率为74%，而供者年龄在17岁以下时为27%（生存曲线的对数秩检验，p<0.001）。在双变量分析中，其他似乎易患慢性GVHD的因素包括受者年龄大于17岁（p<0.02）、接受未照射的供者血沉棕黄层细胞治疗（p<0.01）、II-IV级急性GVHD（p<0.01）以及先前的巨细胞病毒（CMV）感染（p<0.01）。然而，在多变量分析中，只有供者年龄大于17岁、接受供者血沉棕黄层细胞治疗以及II-IV级急性GVHD与慢性GVHD显著相关。讨论了CMV感染在慢性GVHD发生中的可能作用。
