Risk Factors and Outcomes of Graft Versus Host Disease in Acute Leukemia Patients Undergoing Hematopoietic Stem Cell Transplant

Yasir Abbas; Mehreen Ali  Khan; Raheel  Iftikhar; Ammad  Akram; Awais  Siddique; Mehwish  Gilani

doi:10.51253/pafmj.v76iSUPPL-3.12202

Authors

Yasir Abbas Department of Clinical Hematology, Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Mehreen Ali Khan Department of Clinical Hematology, Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Raheel Iftikhar Department of Clinical Hematology, Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Ammad Akram Department of Clinical Hematology, Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Awais Siddique Department of Clinical Hematology, Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Mehwish Gilani Department of Chemical Pathology, Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-3.12202

Keywords:

Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, Graft Versus Host Disease

Abstract

Objective: To evaluate the risk factors and outcomes of Graft Versus Host Disease (GVHD) in Acute leukemia patients undergoing matched-related donor hematopoietic stem cell transplant.

Study Design: Retrospective observational study.

Place and Duration of Study: Armed Forces Bone Marrow Transplant Center, Rawalpindi Pakistan, from May 2006 to Aug 2022.

Methodology: This study enrolled a total of 101 patients diagnosed with Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL) who underwent HSCT at the Armed Forces Bone Marrow Transplant Center (AFBMTC) between May 2006 and August 2022. Data variables included Patients demographic characteristics, disease and donor type, stem cells source and dose, post-transplant complications and survival status.

Results: The study included 76(75.2%) males and 25(24.7%) females, having a male-to-female ratio of 3:1. The mean age was 23.0±11.05 years. Total of 36 patients (35.1%) developed acute graft versus host disease (aGVHD) while Chronic GVHD (cGVHD) was identified in 23(22.8%) patients. Acute graft versus host disease had a statistically significant association with gender mismatch (p-value =0.01), mucositis (p-value =0.011), Cytomegalovirus reactivation (p-value =0.014) and higher total nucleated cell (p-value =0.018) while cGVHD had a statistically significant correlation with gender mismatch (p-value =0.021), CMV reactivation (<0.001) and higher Total nucleated cell (TNC) dose (5.7 x 108/kg p-value <0.001). The overall survival at median follow up of 09 months (OS) for ...

Conclusion: Gender mismatch, CMV reactivation, mucositis and high stem cell dose are associated with increased risk of GVHD. Conditioning protocols should consider optimizing...

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