Chronic Graft-Versus-host Disease May Be Preventable NEW YORK (Reuters Health) Sept 20, 2002 Chronic graft-versus-host disease (cGVHD) may be preventable through the use of cord blood stem cell transplants and preparative regimens without radiotherapy, according to a report in the August 15th issue of Blood. Knowledge of the risk factors for cGVHD might help reduce its incidence, the authors explain, but the risk factors for cGVHD in children remain poorly defined. Dr. Marco Zecca from Policlinico San Matteo in Pavia, Italy and colleagues studied data from 696 consecutive children who underwent allogeneic hematopoietic stem cell transplantation for malignant or nonmalignant diseases in an effort to identify risk factors predicting the development of cGVHD and its outcome. One hundred seventy-three (25%) of the children developed cGVHD a median 116 days post-transplant, the authors report, and the cumulative 2-year probability of cGVHD was 27%. Resolution of cGVHD occurred after a median 5 months in 121 patients (70%), the results indicate. In those children with continuing cGVHD, the cumulative probability of death was 12%. Previous grade II to IV acute GVHD more than doubled the risk contributing of developing cGVHD, the researchers note, and other important risks factors included patient age 15 years or older, donor age 5 years or older, female donor and male recipient, use of total body irradiation as part of the conditioning regimen, and the diagnosis of hematologic malignancy. In contrast, children who received transplants of cord blood stem cells faced only 7% of the risk of cGVHD faced by other recipients, the report indicates. Patients with cGVHD experienced a significantly higher risk of transplant-related death, compared to those without cGVHD, the investigators report. Nevertheless, cGVHD was associated with an important graft-versus-leukemia effect, particularly in patients with acute lymphoblastic leukemia (ALL). The development of cGVHD had a favorable impact on disease-free survival, the report indicates, but only among children with ALL, in whom the cumulative probability of disease-free survival was 74% in those with cGVHD and 47% in those without cGVHD. "Our data document that children have a lower incidence of cGVHD compared with adults," the authors conclude. "Use of cord blood stem cells and of conditioning regimens without total body irradiation, as well as better strategies for preventing acute GVHD occurrence, could further decrease the risk of this complication." Blood 2002;100:1192-1200. Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.