Abstract
We evaluated the incidence, risk factors for cGvHD and clinical outcome in 80 pediatric patients (36 male and 44 female) (median age 13 years; range 1 to 18) who underwent allogeneic PBPC transplantation. All patients were grafted from an HLA-identical sibling after myeloablative conditioning (TBI-based 52; non-TBI 28). GvHD prophylaxis used were CsA+ short methotrexate in 52 and CsA± predinosone in 28. The median number of CD34+ cells infused was 5.8 x 106/Kg (range; 1.4–32.8). The median follow-up was 24 months (range; 3–94). Twenty-eight patients had cGvHD. The cumulative incidence of cGvHD at 24 months was 54.2±10%. Factors that were found significant on univariate analysis were diagnosis (p = 0.03) and GvHD prophylaxis used (p = 0.04). A trend to higher risk of cGvHD was found with higher numbers of CD34+ and CD3+ cells infused. On multivariate analysis, only the GvHD prophylaxis used other than CsA plus short MTX was associated with a significant risk of cGvHD (HR 3.94; 95% CI: 1.41–10.91, p = 0.009). The cumulative incidence of cGvHD for patients receiving MTX was 40.9±12% whereas for patients who did not received MTX was 76.5±18% (HR 2.39; 95% CI: 1.05–7.49; p = 0.03).
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