Frequency and Outcome of Graft versus Host Disease after Stem Cell Transplantation: A Six-Year Experience from a Tertiary Care Center in Pakistan.

ISRN Hematology Pub Date : 2013-06-27 Print Date: 2013-01-01 DOI:10.1155/2013/232519
Natasha Ali, Salman Naseem Adil, Mohammad Usman Shaikh, Nehal Masood
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引用次数: 7

Abstract

Objective. The objective of this study was to evaluate the frequency and outcome of graft versus host disease after stem cell transplantation for various haematological disorders in Pakistan. Materials and Methods. Pretransplant workup of the patient and donor was performed. Mobilization was done with G-CSF 300  μ g twice daily for five day. Standard GvHD prophylaxis was done with methotrexate 15 mg/m(2) on day +1 followed by 10 mg/m(2) on days +3 and +6 and cyclosporine. Grading was done according to the Glucksberg classification. Results. A total of 153 transplants were done from April 2004 to December 2011. Out of these were allogeneic transplants. There were females and males. The overall frequency of any degree of graft versus host disease was 34%. Acute GvHD was present in patients while had chronic GvHD. Grade II GvHD was present in patients while grade III and IV GvHD was seen in patients each. Acute myeloid leukemia and chronic myeloid leukemia were most commonly associated with GvHD. The mortality in acute and chronic GvHD was 8.8% and 12% respectively. Conclusion. The frequency of graft versus host disease in this study was 34% which is lower compared to international literature. The decreased incidence can be attributed to reduced diversity of histocompatibility antigens in our population.

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Abstract Image

干细胞移植后移植物抗宿主病的频率和结果:巴基斯坦三级医疗中心6年的经验
目标。本研究的目的是评估巴基斯坦各种血液病干细胞移植后移植物抗宿主病的频率和结果。材料与方法。对患者和供体进行移植前检查。用g - csf 300 μ g进行动员,每天2次,连续5天。标准的GvHD预防是在第1天使用甲氨蝶呤15mg /m(2),然后在第3天和第6天使用10mg /m(2)和环孢素。根据Glucksberg分类进行评分。结果。2004年4月至2011年12月共移植153例。这些是异体移植。有女性也有男性。任何程度的移植物抗宿主病的总频率为34%。慢性GvHD患者存在急性GvHD。患者存在II级GvHD,而患者分别出现III级和IV级GvHD。急性髓性白血病和慢性髓性白血病最常与GvHD相关。急性和慢性GvHD的死亡率分别为8.8%和12%。结论。本研究中移植物抗宿主病的发生率为34%,与国际文献相比较低。发病率的下降可归因于我们人群中组织相容性抗原多样性的减少。
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