Clinical characteristics of acute graft-versus-host disease confined solely to gastrointestinal tract after allogeneic hematopoietic stem cell transplantation / 中华内科杂志

ABSTRACT

Objective To observe the characteristics of acute graft-versus-host disease (aGVHD) confined solely to gastrointestinal tract after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods Clinical data of 307 patients who received allo-HSCT in our hospital between November 2007 and December 2008 were retrospectively analyzed. Clinical features, risk factors, therap(e)utic effects and prognosis of 38 patients whose aGVHD confined solely to gastrointestinal tract after allo-HSCT were analyzed.Results The incidence of aGVHD was 56. 7% (174/307). aGVHD confined solely to gastrointestinal tract occurred in 38 out of 174 patients (21.8%). The incidence of aGVHD confined solely to gastrointestinal tract was affected by human leukocyte antigen (HLA)-compatible level. The patients transplanted from HLA-matched donor had a higher probability of aGVHD confined solely to the gastrointestinal tract. After treatment with glucocorticoids or anti-CD25 monoclonal antibody, 2 patients who had aGVHD confined solely to the gastrointestinal tract died of uncontrolled aGVHD and concurrent infection. The total effective rate was 94.7%. But for patients who had aGVHD between Ⅱ-Ⅳ degree and not confined solely to gastrointestinal,therapeutic effective rate was 85.2%. There was a difference in therapeutic effect between the two groups (P =0. 015). Anti-CD25 monoclonal antibody was used in 12 patients who had aGVHD confined solely to the gastrointestinal tract and all patients' conditions of aGVHD were controlled. Conclusions aGVHD confined solely to gastrointestinal tract after HSCT was not rare. The incidence of aGVHD confined solely to gastrointestinal tract was higher in HLA-matched sibling donor than in mismatched transplantation.Therapeutic efficacy for the aGVHD confined solely to gastrointestinal tract was good. The favorable outcome might be related with the application of anti-CD25 monoclonal antibody.