Allogeneic peripheral blood stem cell transplantation may be associated with a high risk of chronic graft-versus-host disease

被引:260
作者
Storek, J [1 ]
Gooley, T [1 ]
Siadak, M [1 ]
Bensinger, WI [1 ]
Maloney, DG [1 ]
Chauncey, TR [1 ]
Flowers, M [1 ]
Sullivan, KM [1 ]
Witherspoon, RP [1 ]
Rowley, SD [1 ]
Hansen, JA [1 ]
Storb, R [1 ]
Appelbaum, FR [1 ]
机构
[1] UNIV WASHINGTON,DEPT MED,SEATTLE,WA 98195
关键词
D O I
10.1182/blood.V90.12.4705.4705_4705_4709
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Chronic graft-versus-host disease (GVHD) is likely caused by donor T lymphocytes. Because unmodified blood stem cell grafts contain one log more T lymphocytes than unmodified marrow grafts, we evaluated the incidence of chronic GVHD in previously reported 37 blood stem cell recipients and 37 computer-matched historical control marrow recipients (Bensinger et al, Blood 88:2794, 1996). AII patients have been followed until death, relapse, or occurrence of chronic GVHD or for a minimum of 2 years. In a univariable proportional hazards regression model, the relative risk of developing clinical chronic GVHD (includes clinical limited and clinical extensive disease) by 2 years posttransplant among the peripheral blood stem cell recipients compared with the marrow recipients was 2.22 (95% confidence interval, 1.04 to 4.74; P =.039). For clinical extensive chronic GVHD, the relative risk was 2.37 (95% confidence interval, 1.07 to 5.29; P =.035). In multivariable analyses, considering also the covariables of patient age, patient cytomegalovirus serostatus, and donor cytomegalovirus serostatus, the relative risks of clinical chronic GVHD and clinical extensive chronic GVHD were also greater than 2 (P <.05). We conclude that the transplantation of unmanipulated filgrastim-mobilized blood stem cells may result in a relatively high incidence of chronic GVHD. (C) 1997 by The American Society of Hematology.
引用
收藏
页码:4705 / 4709
页数:5
相关论文
共 42 条
[11]   Monocytes from mobilized stem cells inhibit T cell function [J].
Ino, K ;
Singh, RK ;
Talmadge, JE .
JOURNAL OF LEUKOCYTE BIOLOGY, 1997, 61 (05) :583-591
[12]   ALLOGENEIC BLOOD STEM-CELL TRANSPLANTATION FOR REFRACTORY LEUKEMIA AND LYMPHOMA - POTENTIAL ADVANTAGE OF BLOOD OVER MARROW ALLOGRAFTS [J].
KORBLING, M ;
PRZEPIORKA, D ;
HUH, YO ;
ENGEL, H ;
VANBESIEN, K ;
GIRALT, S ;
ANDERSSON, B ;
KLEINE, HD ;
SEONG, D ;
DEISSEROTH, AB ;
ANDREEFF, M ;
CHAMPLIN, R .
BLOOD, 1995, 85 (06) :1659-1665
[13]  
KORBLING M, 1997, BONE MARROW TRANS S1, V19, pS72
[14]   Granulocyte colony-stimulating factor-induced comobilization of CD4(-)CD8(-) T cells and hematopoietic progenitor cells (CD34(+)) in the blood of normal donors [J].
KusnierzGlaz, CR ;
Still, BJ ;
Amano, M ;
Zukor, JD ;
Negrin, RS ;
Blume, KG ;
Strober, S .
BLOOD, 1997, 89 (07) :2586-2595
[15]  
Majolino I, 1996, BONE MARROW TRANSPL, V17, P555
[16]   Suppression of alloantigen-induced T-cell proliferation by CD14(+) cells derived from granulocyte colony-stimulating factor-mobilized peripheral blood mononuclear cells [J].
Mielcarek, M ;
Martin, PJ ;
TorokStorb, B .
BLOOD, 1997, 89 (05) :1629-1634
[17]   Responses of granulocyte colony-stimulating factor-mobilized peripheral blood mononuclear cells to alloantigen stimulation [J].
Nawa, Y ;
Teshima, T ;
Sunami, K ;
Hiramatsu, Y ;
Yano, T ;
Shinagawa, K ;
Omoto, E ;
Harada, M .
BLOOD, 1997, 90 (04) :1716-1718
[18]  
NIEDERWIESER D, 1989, BONE MARROW TRANSPL, V4, P151
[19]   LATE INFECTIONS AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION - COMPARISON OF INCIDENCE IN RELATED AND UNRELATED DONOR TRANSPLANT RECIPIENTS [J].
OCHS, L ;
SHU, XO ;
MILLER, J ;
ENRIGHT, H ;
WAGNER, J ;
FILIPOVICH, A ;
MILLER, W ;
WEISDORF, D .
BLOOD, 1995, 86 (10) :3979-3986
[20]   Improved immune reconstitution after allotransplantation of peripheral blood stem cells instead of bone marrow [J].
Ottinger, HD ;
Beelen, DW ;
Scheulen, B ;
Schaefer, UW ;
GrosseWilde, H .
BLOOD, 1996, 88 (07) :2775-2779