Age influences post-graft-versus-host disease non-relapse mortality in adults with acute graft-versus-host disease of varying severity following allogeneic hematopoietic cell transplant

Abstract

We retrospectively analyzed 2682 patients who developed grade II–IV acute graft-versus-host disease (GVHD). On analysis with stratification into five age groups (20–29, 30–39, 40–49, 50–59 and ≥ 60), 2-year non-relapse mortality rates (NRM) after the onset of GVHD were 20.7, 26.2, 26.6, 37.0 and 40.4%, respectively (p < 0.001). We found a significant interaction between the patient's age and GVHD severity with respect to NRM (p = 0.004). On multivariate analyses stratified by GVHD severity, the hazard ratio (HR) for NRM in the groups aged 50 years or more (reference: age group 20–29) was about twice as great in patients with grade II acute GVHD when compared with grade III–IV disease (HR in those aged 50–59 years: 2.9 for grade II and 1.5 [p = 0.03 and 0.04] for grades III–IV; HR if ≥ 60 years: 3.3 for grade II and 1.5 for grades III–IV [p < 0.001 for both]).

Keywords::

• Clinical results
• graft-versus-host disease
• transplant toxicity

Acknowledgements

We thank all of the medical staff who provided care for these patients, and the data managers of the JSHCT.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.

This work was supported in part by a Research Grant for Allergic Disease and Immunology (H23-013) from the Japanese Ministry of Health, Labor and Welfare.