Characteristics of the study cohort
| Characteristic . | Cohort, N = 977 . |
|---|---|
| Median time from transplantation to initial systemic treatment for chronic GVHD, mo (range) | 5.3 (2.5–33.5) |
| Median patient age at transplantation, y (range) | 48 (0–78) |
| Median donor age at transplantation, y (range) | 39 (0–78) |
| Patient gender, no. (%) | |
| Male | 565 (58) |
| Female | 412 (42) |
| Donor–recipient gender combination, no. (%) | |
| Male to male | 297 (30) |
| Female to male | 268 (27) |
| Male to female | 179 (18) |
| Female to female | 233 (24) |
| Patient race, no. (%) | |
| Caucasian | 766 (78) |
| African American | 16 (2) |
| Other | 166 (17) |
| Missing data | 29 (3) |
| Diagnosis, no. (%) | |
| Acute myeloid leukemia | 301 (31) |
| Acute lymphoid leukemia | 105 (11) |
| Chronic myeloid leukemia | 108 (11) |
| Myelodysplastic syndromes or myeloproliferative neoplasms | 212 (22) |
| Chronic lymphocytic leukemia | 40 (4) |
| Malignant lymphoma | 105 (11) |
| Multiple myeloma | 59 (6) |
| Aplastic anemia | 14 (1) |
| Other | 33 (3) |
| Disease risk,* no. (%) | |
| Low | 337 (34) |
| High | 640 (66) |
| Stem cell graft source, no. (%) | |
| Bone marrow | 143 (15) |
| Mobilized blood cells | 820 (84) |
| Umbilical cord blood | 14 (1) |
| HLA and donor type, no. (%) | |
| HLA matched related | 406 (42) |
| HLA matched unrelated | 373 (38) |
| HLA mismatched related | 36 (4) |
| HLA mismatched unrelated | 162 (17) |
| ABO compatibility, no. (%) | |
| Match | 533 (55) |
| Minor mismatch | 197 (20) |
| Major mismatch | 247 (25) |
| Intensity of conditioning regimen, no. (%) | |
| High | 693 (71) |
| Reduced | 284 (29) |
| TBI dose in conditioning regimen, no. (%) | |
| None | 385 (39) |
| ≤450 cGy | 360 (37) |
| >450 cGy | 232 (24) |
| ATG in conditioning regimen, no. (%) | 54 (6) |
| GVHD prophylaxis, no. (%) | |
| Cyclosporine + MTX/MMF | 593 (61) |
| Tacrolimus + MTX/MMF | 350 (36) |
| Other | 34 (3) |
| Prior grade II–IV acute GVHD, no. (%) | 725 (74) |
| Prior stage 3–4 skin acute GVHD, no. (%) | 359 (37) |
| Sites involved with chronic GVHD at initial systemic treatment, no. (%) | |
| Skin | 674 (69) |
| Eye | 267 (27) |
| Mouth | 740 (76) |
| Gastrointestinal tract | 374 (38) |
| Liver | 254 (26) |
| Lung (bronchiolitis obliterans) | 16 (2) |
| Joint or fascia | 63 (6) |
| Genital tract | 45 (5) |
| Eosinophilia >400/μL at initial systemic treatment, no. (%) | 156 (16) |
| Thrombocytopenia <100 000/μL at initial systemic treatment, no. (%) | 318 (33) |
| Progressive onset,† no. (%) | 339 (35) |
| Characteristic . | Cohort, N = 977 . |
|---|---|
| Median time from transplantation to initial systemic treatment for chronic GVHD, mo (range) | 5.3 (2.5–33.5) |
| Median patient age at transplantation, y (range) | 48 (0–78) |
| Median donor age at transplantation, y (range) | 39 (0–78) |
| Patient gender, no. (%) | |
| Male | 565 (58) |
| Female | 412 (42) |
| Donor–recipient gender combination, no. (%) | |
| Male to male | 297 (30) |
| Female to male | 268 (27) |
| Male to female | 179 (18) |
| Female to female | 233 (24) |
| Patient race, no. (%) | |
| Caucasian | 766 (78) |
| African American | 16 (2) |
| Other | 166 (17) |
| Missing data | 29 (3) |
| Diagnosis, no. (%) | |
| Acute myeloid leukemia | 301 (31) |
| Acute lymphoid leukemia | 105 (11) |
| Chronic myeloid leukemia | 108 (11) |
| Myelodysplastic syndromes or myeloproliferative neoplasms | 212 (22) |
| Chronic lymphocytic leukemia | 40 (4) |
| Malignant lymphoma | 105 (11) |
| Multiple myeloma | 59 (6) |
| Aplastic anemia | 14 (1) |
| Other | 33 (3) |
| Disease risk,* no. (%) | |
| Low | 337 (34) |
| High | 640 (66) |
| Stem cell graft source, no. (%) | |
| Bone marrow | 143 (15) |
| Mobilized blood cells | 820 (84) |
| Umbilical cord blood | 14 (1) |
| HLA and donor type, no. (%) | |
| HLA matched related | 406 (42) |
| HLA matched unrelated | 373 (38) |
| HLA mismatched related | 36 (4) |
| HLA mismatched unrelated | 162 (17) |
| ABO compatibility, no. (%) | |
| Match | 533 (55) |
| Minor mismatch | 197 (20) |
| Major mismatch | 247 (25) |
| Intensity of conditioning regimen, no. (%) | |
| High | 693 (71) |
| Reduced | 284 (29) |
| TBI dose in conditioning regimen, no. (%) | |
| None | 385 (39) |
| ≤450 cGy | 360 (37) |
| >450 cGy | 232 (24) |
| ATG in conditioning regimen, no. (%) | 54 (6) |
| GVHD prophylaxis, no. (%) | |
| Cyclosporine + MTX/MMF | 593 (61) |
| Tacrolimus + MTX/MMF | 350 (36) |
| Other | 34 (3) |
| Prior grade II–IV acute GVHD, no. (%) | 725 (74) |
| Prior stage 3–4 skin acute GVHD, no. (%) | 359 (37) |
| Sites involved with chronic GVHD at initial systemic treatment, no. (%) | |
| Skin | 674 (69) |
| Eye | 267 (27) |
| Mouth | 740 (76) |
| Gastrointestinal tract | 374 (38) |
| Liver | 254 (26) |
| Lung (bronchiolitis obliterans) | 16 (2) |
| Joint or fascia | 63 (6) |
| Genital tract | 45 (5) |
| Eosinophilia >400/μL at initial systemic treatment, no. (%) | 156 (16) |
| Thrombocytopenia <100 000/μL at initial systemic treatment, no. (%) | 318 (33) |
| Progressive onset,† no. (%) | 339 (35) |
ATG, antithymocyte globulin; MTX, methotrexate; MMF, mycophenolate mofetil.
The low-risk category included chronic myeloid leukemia in chronic phase, acute leukemia in first remission, myelodysplastic syndrome without excess blasts, and aplastic anemia. The high-risk category included all other diseases and stages.
Direct progression from acute GVHD to chronic GVHD or onset of chronic GVHD during steroid treatment.