Canterbury DHB

Context

Prognosis of cGvHD

In a CIBMTR study, Arora et al identified 10 risk factors which were significant for outcome in multi-variate analysis of 5343 patients who had undergone an allogeneic transplant from a related or unrelated donor for AML, ALL, MDS or CML between 1995-2004. These 10 variables were used to identify six risk groups.

Risk factor

0

1

2

Age (years)

<29

30-59

>60

Prior acute GvHD

None

Present

 

Time from transplantation to cGvHD

>5 months

<5 months

 

Serum bilirubin at cGvHD onset

<2 mg/dl

</=34

>2 mg/dl

>34

 

KPS at cGvHD onset

>/=80

<80

 

Platelet count at cGvHD onset

</=100

>100

 

Type of donor

HLA-identical sibling

7/8 or 8/8 MUD

Other related/mismatched MUD

 

Disease status at transplant1

Early

Intermediate

Advanced

Sex mismatch (donor/recipient)

M/M, M/F, F/F

F/M

 

GvHD prophylaxis

CSA+MTX+other

Tacrolimus+MTX +other or TCD

 

Early disease = allograft in CR1 (acute leukemia) or first chronic phase (CML) or MDS categories RA or RARS; Intermediate disease = CR2 or later (ALL) or second chronic phase/accelerated phase or later (CML); Advanced disease = patients in relapse or with refractory disease (acute leukemia) or blast crisis (CML) or MDS categories RAEB or RAEB in transformation.

5-year OS and NRM according to the cGvHD score

Score

Risk group

OS

NRM

0-2

1

91

4.6

3-6

2

67

20

7-8

3

51

33

9-10

4

40

43

11

5

21

63

>12

6

4

72

>11

5+6

14.5

67

Further reading

About this Canterbury DHB document (112962):

Document Owner:

Not assigned (see Who's Who)

Issue Date:

December 2016

Next Review:

December 2018

Keywords:

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Topic Code: 112962