Analytical Study on Acute and Chronic GvHD Occurrence in a Series of Pediatric Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Publish Year: 1397
نوع سند: مقاله کنفرانسی
زبان: English
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NSCMRMED03_142

تاریخ نمایه سازی: 30 دی 1397

Abstract:

Background and Aim: Graft-versus-host disease (GvHD) is one of themain complications following allogeneic hematopoietic stem celltransplantation (allo-HSCT). In this study, we reported the epidemiologicprofile and outcomes of pediatric patients undergoing allo-HSCT at areference pediatric HSCT center in Iran. We also analyzed the impact ofdemographic, clinical and treatment-related variables on the occurrenceof acute and chronic GvHD (aGvHD and cGvHD).Methods: In this retrospective cross-sectional study, one-hundredpediatric patients (57% male) who underwent allo-HSCT betweenSeptember 2016 and February 2018 at the department of pediatric stemcell transplantation in Children’s Medical Center, Tehran, Iran wereincluded. Data were extracted from patients’ records and were enteredinto a predesigned checklist.Results: Thirty-eight patients developed aGvHD, with the highestpercentage having grade I (16%), followed by grade II (9%), grade III(7%) and grade IV (6%) aGvHD. Twelve patients developed cGvHD withthe majority having limited (8%) followed by extensive (4%) cGvHD.The source of HSCs was peripheral blood in the majority of cases (88%).The disease class of the patients was hematologic malignancies (33%),primary immunodeficiencies (23%), inborn errors of metabolism (12%)and hematologic abnormalities (32%). The occurrence of aGvHD wassignificantly more common in patients with primary immunodeficienciesand hematologic abnormalities compared with the other two classes ofdiseases (P=0.038). Other variables such as gender, age, donor-recipientrelationship, donor-recipient matching, the source of HSC, etc did nothave any impact on the occurrence of aGvHD and cGvHD. aGvHD wassuccessfully managed with standard care. Nine patients died during thestudy period and only one of them was related to GvHD (acute). Patientswith cGvHD are still under observation in follow-up visits.Conclusion: The occurrence of aGvHD and cGvHD in allo-HSCT treatedpediatric patients was less than two-fifths of patients and a little greaterthan one-tenths of patients, respectively. The underlying disease mayhave an impact on the occurrence of aGvHD.

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Authors

Poorya Salajegheh

Department of Pediatric Stem Cell Transplantation, Children’s Medical Center, Tehran University of Medical Sciences,Tehran, Iran- Department of Pediatrics, Kerman University of Medical Sciences, Kerman, Iran

Seyed Mostafa Monzavi

Department of Pediatric Stem Cell Transplantation, Children’s Medical Center, Tehran University of Medical Sciences,Tehran, Iran

Amir Ali Hamidieh

Department of Pediatric Stem Cell Transplantation, Children’s Medical Center, Tehran University of Medical Sciences,Tehran, Iran

Alieh Safari Sharafi

Department of Pediatric Stem Cell Transplantation, Children’s Medical Center, Tehran University of Medical Sciences,Tehran, Iran