Conjunctival Acute Graft-versus-Host Disease in Adult Patients Receiving Allogeneic Hematopoietic Stem Cell Transplantation: A Cohort StudyReport as inadecuate




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Background

To investigate the incidence, risk factors and survival of conjunctival acute graft-versus-host disease aGVHD in adult patients undergoing allogeneic hematopoietic stem cell transplantation HSCT

Methods

This retrospective study included a total of 139 patients undergoing allogeneic HSCT between January 2012 and December 2014 at a tertiary referral hospital. Patients with ocular complaints after allogeneic HSCT or first donor lymphocyte infusion were evaluated by ophthalmologists. The risk factors for conjunctival aGVHD were analyzed using the Cox proportional hazards model. The overall survival was evaluated using Kaplan-Meier estimates.

Results

Thirteen 9.4% patients developed conjunctival aGVHD, including eight patients with pseudomembranous conjunctivitis. The cumulative incidence of conjunctival aGVHD was 2.1 cases per 10,000 person-day. The median age at HSCT was 47 years range, 18 to 66 in all patients and 42 years range, 24 to 58 in the 13 patients with conjunctival aGVHD. Median time of follow-up after allogeneic HSCT was 353 days range, 11 to 1184. In univariate analysis, grades II-IV skin aGVHD P = 0.002 and advanced systemic aGVHD except skin aGVHD overall grades III-IV P = 0.001 were significant predictors for conjunctival aGVHD. In multivariate analysis, grades II-IV skin aGVHD was a significant risk factor P = 0.04. The severity of conjunctival aGVHD was generally correlated with the systemic aGVHD P = 0.001. Overall survival was significantly shorter in patients with grades II-IV aGVHD compared to those with grade 0-I P = 0.01. Survival in patients with conjunctival aGVHD did not differ significantly from those without this complication P = 0.94. In the subgroup analysis of patients with grades III-IV aGVHD, survival was significantly longer in patients with conjunctival involvement than those without P = 0.03.

Conclusions

The severity of conjunctival aGVHD is correlated with systemic aGVHD, but not with inferior overall survival.



Author: Yao-Chung Liu, Jyh-Pyng Gau, Pei-Yu Lin, Catherine Jui-Ling Liu, Chia-Jen Liu, Jin-Hwang Liu, Nai-Wen Fan

Source: http://plos.srce.hr/



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