Mehdizadeh Mahshid, Parkhideh Sayeh, Salari Sina, Roshandel Elham, Kazemi Mohammad Hossein, Bonakchi Hossein, Soleimani Masoud, Hajifathali Abbas
Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2021 Nov 2;35:145. doi: 10.47176/mjiri.35.145. eCollection 2021.
Graft-versus-host disease (GVHD) is a serious complication associated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Thus, it is necessary to evaluate the risk factors of GVHD in allo-HSCT. Herein, we studied the effects of some risk factors on GVHD incidence in patients with allo-HSCT. We retrospectively evaluated the GVHD incidences and risk factors in 199 patients diagnosed with hematological disorders who underwent allo-HSCT in Taleghani hospital, Tehran, Iran, between 2007 and 2017. The univariable and multivariable analyses of time to event data were performed using the Logistic regression model. Computations were performed using SAS, and the level of statistical significance for univariable and multivariable analyses was set at 20% and 10%, respectively. Acute GVHD (aGVHD) was seen in 59 (29.6%) patients, and 18 (9%) patients developed chronic GVHD (cGVHD). The odds of GVHD incidence in male to female transplants was 3.49 times greater than the male-to-male transplantations (CI, 1.16, 11.5; p<0.001). The patients with body mass index (BMI) below 18.5 had 96% lower odds of GVHD incidence compared with those with BMI above 30 (CI, 0.007-0.27; p=0.013). The odds of GVHD incidence in patients who were negative for cytomegalovirus (CMV) antigen was 76% lower than patients with positive CMV antigen (CI, 0.06-0.93; p=0.081). In a nutshell, our results indicated that the donor-recipient gender disparity, the recipient's BMI, and CMV infection/reactivation status might be pivotal risk factors, which should be taken into account for prevention and management of GVHD.
移植物抗宿主病（GVHD）是异基因造血干细胞移植（allo-HSCT）相关的一种严重并发症。因此，有必要评估allo-HSCT中GVHD的危险因素。在此，我们研究了一些危险因素对allo-HSCT患者GVHD发生率的影响。我们回顾性评估了2007年至2017年期间在伊朗德黑兰塔莱加尼医院接受allo-HSCT的199例诊断为血液系统疾病患者的GVHD发生率及危险因素。使用逻辑回归模型对事件发生时间数据进行单变量和多变量分析。计算使用SAS进行，单变量和多变量分析的统计学显著性水平分别设定为20%和10%。59例（29.6%）患者发生急性GVHD（aGVHD），18例（9%）患者发生慢性GVHD（cGVHD）。男性对女性移植中GVHD发生的几率比男性对男性移植高3.49倍（置信区间，1.16，11.5；p<0.001）。体重指数（BMI）低于18.5的患者GVHD发生几率比BMI高于30的患者低96%（置信区间，0.007 - 0.27；p = 0.013）。巨细胞病毒（CMV）抗原阴性患者GVHD发生几率比CMV抗原阳性患者低76%（置信区间，0.06 - 0.93；p = 0.081）。简而言之，我们的结果表明供受者性别差异、受者BMI以及CMV感染/再激活状态可能是关键危险因素，在GVHD的预防和管理中应予以考虑。
