Chronic Graft versus Host Disease after Allogeneic Bone Marrow Transplantation; An Analysis of Incidence and Risk Factors.

Chronic graft versus host disease (cGVHD) is one of the most serious potential complications ofallogeneic bone marrow transplantation.Study design and We analyzed the incidence of cGVHD and its associated risk factors in a group of 161Iranian recipients of HLA-identical sibling transplants, with at least 90 days post-transplantation survival. In themajority of cases (n=73), cGVHD occurred in the first year after the transplant (median 273 days). The actualprobability of cGVHD within 1 year was 45.3±7% (CI 95%). In a univariate analysis, the most important risk factor was the type of transplant. Peripheral blood stem celltransplants (PBSCT) showed a significant increase in cGVHD compared with bone marrow transplants (BMT)(RR=2.34, p<0.001). In addition, male recipients were at a greater risk than female recipients (RR=2.08, p=0.004).Other risk factors were the presence of prior acute GVHD (RR=2.37, p=0.04) and the previous acute GVHD grade(p=0.03); The probabilities of cGVHD in patients with grade 0, Ι, ΙІ, ΙΙΙ, ΙV acute GVHD were 24%, 44.7%, 42.6%,56.8%, 64.3%, respectively. In a multivariate analysis, the only independent predictive factors for the development of cGVHD were the type of transplant (PBSC>BM, p<0.001) and male recipient (p=0.005). The survival rate was 88.8% and there was no significant difference in the probability of survival between BPSCT vs BMT (93.8% vs 86.6%, p=0.5).