An ethnic role for chronic, but not acute, graft-versus-host disease after HLA-identical sibling stem cell transplantation

Eur J Haematol. 2001 Jan;66(1):50-6. doi: 10.1034/j.1600-0609.2001.00331.x.

Abstract

Among 424 HLA identical siblings undergoing stem cell transplantation, 364 were Scandinavians and 60 represented other ethnic groups. The cumulative probabilities of acute graft-versus-host disease grades II-IV were similar in both groups, 17% in Scandinavians and 12% in the others, p = 0.4. In a multivariate analysis, less effective immune suppression with cyclosporine or methotrexate alone (p = 0.001), recipient seropositive for three to four herpes viruses (p = 0.004), CMV-seropositive recipient (p = 0.05) and early engraftment (before day 15) (p = 0.05) were independent risk-factors for acute GVHD grades II-IV. The cumulative probabilities of chronic GVHD were 47% and 68% in the two ethnic populations, respectively (p = 0.004). In multivariate analysis, higher patient age (p < 0.001), non-Scandinavian population (p < 0.001) and immunised female donor to male recipient (p = 0.03) were independent risk factors for chronic GVHD. The higher incidence of chronic GVHD could not be explained by differences in HLA antigen frequencies. The cumulative probabilities of relapse were 37% in the both groups. This suggests that the Scandinavian population is more homogeneous with regard to minor histocompatibility antigens important for chronic, but not acute GVHD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Africa / ethnology
  • Aged
  • Anemia, Aplastic / therapy
  • Asia / ethnology
  • Child
  • Child, Preschool
  • Chronic Disease
  • Cytomegalovirus / growth & development
  • Cytomegalovirus Infections / ethnology
  • Cytomegalovirus Infections / etiology
  • Europe / ethnology
  • Fanconi Anemia / therapy
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Graft vs Host Disease / ethnology*
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / immunology
  • HLA Antigens / immunology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Histocompatibility
  • Humans
  • Incidence
  • Infant
  • Life Tables
  • Logistic Models
  • Male
  • Metabolism, Inborn Errors / therapy
  • Middle Aged
  • Minor Histocompatibility Antigens / immunology
  • Multivariate Analysis
  • Neoplasms / therapy
  • Nuclear Family
  • Recurrence
  • Risk Factors
  • Scandinavian and Nordic Countries / ethnology
  • Survival Analysis
  • Sweden / epidemiology
  • Virus Activation

Substances

  • HLA Antigens
  • Minor Histocompatibility Antigens