The impact of chronic GVHD on survival of Patients with acute myeloid leukemia after non-T-cell depleted HLA-identical sibling peripheral blood stem cells transplantation

Graft versus host disease (GVHD) is among major complications of allogeneic hematopoietic stem cells transplantation, and also is an important factor affecting the outcome of transplantation. An increased incidence of GVHD has been suggested following allogeneic peripheral blood stem cells (PBSC) transplantation, however, how this affects survival is not yet well clear. In this study, our aim was to assess the impact of acute GVHD (aGVHD) and chronic GVHD (cGVHD) on overall survival (OS), disease-free survival (DFS) and relapse following non-T-cell depleted HLA-identical sibling peripheral blood stem cells transplantation (PBSCT). Data of 78 patients, including 40 patients with acute myeloid leukemia (AML) and 38 patients with acute lymphoblastic leukemia (ALL), undergoing non-T-cell depleted HLA-identical sibling allogeneic PBSCT,were analyzed. All patients were received a uniform myeloablative conditioning regimen and prophylaxis for GVHD. We studied the incidence of aGVHD and cGVHD and their effects on survival and relapse in these patients. The overall incidence of aGVHD and chronic GVHD was 82.5% and 42.5% in the AML patients and 84.2% and 26.3% in the ALL patients. The occurrence of aGVHD had no effect on OS, DFS and relapse in AML and ALL patients receiving transplants. Although incidence of 2-year OS and DFS were significantly higher in the AML Patients with cGVHD compared to patients without cGVHD (P=0.024 and P=0.033, respectively), this difference was not due to the low incidence of relapse. These data indicate that the occurrence of cGVHD is an important predictor of outcome of non-T-cell depleted HLA-identical sibling allogeneic PBSCT, in those AML patients who develope cGVHD have a high chance of survival.