Increasing incidence of chronic graft-versus-host disease in allogeneic transplantation: a report from the Center for International Blood and Marrow Transplant Research

Biol Blood Marrow Transplant. 2015 Feb;21(2):266-74. doi: 10.1016/j.bbmt.2014.10.021. Epub 2014 Oct 30.

Abstract

Although transplant practices have changed over the last decades, no information is available on trends in incidence and outcome of chronic graft-versus-host disease (cGVHD) over time. This study used the central database of the Center for International Blood and Marrow Transplant Research (CIBMTR) to describe time trends for cGVHD incidence, nonrelapse mortality, and risk factors for cGVHD. The 12-year period was divided into 3 intervals, 1995 to 1999, 2000 to 2003, and 2004 to 2007, and included 26,563 patients with acute leukemia, chronic myeloid leukemia, and myelodysplastic syndrome. Multivariate analysis showed an increased incidence of cGVHD in more recent years (odds ratio = 1.19, P < .0001), and this trend was still seen when adjusting for donor type, graft type, or conditioning intensity. In patients with cGVHD, nonrelapse mortality has decreased over time, but at 5 years there were no significant differences among different time periods. Risk factors for cGVHD were in line with previous studies. This is the first comprehensive characterization of the trends in cGVHD incidence and underscores the mounting need for addressing this major late complication of transplantation in future research.

Keywords: Allogeneic transplant; Incidence; Nonrelapse mortality; cGVHD.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation / adverse effects*
  • Child
  • Child, Preschool
  • Chronic Disease
  • Female
  • Graft vs Host Disease / etiology*
  • Graft vs Host Disease / mortality
  • Graft vs Host Disease / pathology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Infant
  • Infant, Newborn
  • International Cooperation
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / mortality*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Leukemia, Myeloid, Acute / mortality*
  • Leukemia, Myeloid, Acute / pathology
  • Leukemia, Myeloid, Acute / therapy
  • Male
  • Middle Aged
  • Myeloablative Agonists / therapeutic use
  • Myelodysplastic Syndromes / mortality*
  • Myelodysplastic Syndromes / pathology
  • Myelodysplastic Syndromes / therapy
  • Odds Ratio
  • Survival Analysis
  • Transplantation, Homologous

Substances

  • Myeloablative Agonists