Three-year cumulative incidences of moderate to severe or severe chronic GVHD were 13% and 3%, respectively

Three-year cumulative incidences of moderate to severe or severe chronic GVHD were 13% and 3%, respectively. 47%. The 3-12 months overall survival (OS) was 57%. Age of less than 50 years was associated with better OS. OS in patients with high/very high processed disease risk indexes (rDRIs) Fmoc-Lys(Me3)-OH chloride was comparable to that in those with low/intermediate rDRIs. The 100-day cumulative incidences of grades IICIV and IIICIV acute GVHD were 45% and 18%, respectively. HSCT from a related donor with two allele mismatches showed higher incidences of grades IICIV and IIICIV acute GVHD. Three-year cumulative incidences of moderate to severe or severe chronic GVHD were 13% and 3%, respectively. HSCT from a related donor with one locus mismatch at the antigen level using low-dose ATG showed lower incidences of acute and chronic GVHD, which led to acceptable GRFS, OS, relapse, and nonrelapse mortality. = 38= 0.118) (Fig. 1B). The 1-12 months GRFS for patients with low/intermediate rDRI and high/very high rDRI or that for those with one allele mismatch and two allele mismatches were comparable (rDRI low/intermediate 50% vs high/very high 40%, = 0.980, one allele mismatch 52% vs two allele mismatches 38%, = 0.536) (Fig. 1C, ?,DD). Open in a separate windows Fig.?1. GVHD-free, relapse-free survival for the total cohorts (A), and those stratified by age group (B), disease risk index (C), and the number of allele mismatches at the HLA-A, -B, or -DRB1 locus (D). GVHD: graft-versus-host disease. Neutrophil and Platelet Engraftment The cumulative incidence of neutrophil engraftment at day 42 was 97% (95% CI, 64%C100%) (Fig. 2A). The cumulative incidence of platelet engraftment at day 100 was 82% (95% CI, 64%C91%) (Fig. 2B). There was no primary or secondary graft failure. Open in a separate window Fig.?2. Neutrophil (A) and platelet engraftment (B) for the total cohorts. Acute and Chronic GVHD The cumulative incidences of grades IICIV and IIICIV acute GVHD at day TRUNDD 100 were 45% (95% CI, 28%C60%) and 18% (95% CI, 8%C32%), respectively (Fig. 3A, B). Open in a separate window Fig.?3. Grades IICIV and IIICIV acute GVHD for the total cohorts (A, B), and those stratified by lymphocyte counts (C, D), and the number of allele mismatches at the HLA-A, -B, or DRB1 locus (E, F) and at the HLA-A, -B, -C, or -DRB1 locus (G, H). GVHD: graft-versus-host disease. Lymphocyte counts just before ATG administration were categorized into two groups (high lymphocyte and low lymphocyte) according to the median value of 311/l. There was no significant difference in grade IICIV or IIICIV between these two groups, although the incidence of grade IIICIV acute GVHD was higher in the high lymphocyte group (Fig. 3C, D). The incidence of grade IICIV acute GVHD in the group with two allele mismatches at HLA-A, -B, and -DRB1 was higher than that in the group with one allele mismatch, although there was no statistical difference (Fig. 3E, F). Even if HLA-C is considered in HLA matching, there was no statistical difference (Fig. 3G, H). Grade IIICIV acute GVHD was observed in 8 of 33 patients receiving peripheral blood stem Fmoc-Lys(Me3)-OH chloride cell transplantation, but none in 8 patients receiving bone marrow transplantation. Acute GVHD was treated with a median dose of 1 1 mg/kg of methylprednisolone or prednisolone for 15 patients and an overall treatment response was obtained in 12 patients. The cumulative incidence of any grade, moderate to severe, and severe chronic GVHD at 3 years was 29% (95% CI, 15%C44%), 13% (95% CI, 5%C26%), and 3% (95% CI, 2%C12%), respectively (Fig. 4). There was no significant factor associated with chronic GVHD in the univariate analysis. Open in a separate window Fig.?4. Chronic GVHD of all grades (A), moderate to severe (B), and severe chronic GVHD (C) for the total cohorts. GVHD: graft-versus-host disease. For patients who survived without relapse, the rate of discontinuation of immunosuppressants at 1 year was 75% Fmoc-Lys(Me3)-OH chloride (95% CI, 54%C86%) (Fig. 5). Open in a separate window Fig.?5. Rate of discontinuation of immunosuppressants among those who survived without relapse. Overall and Progression-free Survival The 3-year OS was 57% (95% CI, 39%C71%) (Fig. 6A). Age less than 50 years was associated with better OS (80% vs 38%, = 0.004) (Fig. 6B). OS in patients with high/very high rDRIs was comparable to OS in those with low/intermediate rDRIs (70% vs 53%, = 0.318) (Fig. 6C). The 3-year PFS was 57% (95% CI, 39%C71%) (Fig. 6D). Age less than 50 years was associated with better OS (80% vs 38%, = 0.004) (Fig. 6E). PFS in patients with high/very high rDRIs was comparable to PFS.