BACKGROUND PBSC are increasingly being used as the source of stem cells in allogeneic transplantation. An increased incidence of chronic GvHD has been suggested following unmanipulated allogeneic PBSC transplantation (PBSCT), however, how this affects overall survival is not yet clear. Our aim was to study the impact of chronic GvHD on survival and relapse following allogeneic PBSCT. METHODS We have analyzed data from 73 patients undergoing HLA-matched allogeneic PBSCT. GvHD prophylaxis was with CYA and MTX in 97% of patients. We have studied the incidence of chronic GvHD and its affect on relapse and survival in these patients. All patients were at least 100 days post-transplant at the time of analysis. RESULTS Seventy-three patients were evaluable for analysis of chronic GvHD. The overall incidence of chronic GvHD was 55% (limited in 18% and extensive in 37%). Overall median survival was 991 days, with a 4 year survival rate of 48%. Twelve patients relapsed. Patients with chronic GvHD had a significantly lower incidence of disease relapse (p = 0.005) with a relapse probability of 8% at 3 years, compared with 40% in patients with no chronic GvHD. In addition, the extent of chronic GvHD had a marked effect on survival, patients with limited chronic GvHD had a 4 year survival rate of 83%, compared with 45% in patients with extensive chronic GvHD and 38% in patients with no chronic GvHD. This difference was primarily due to the low incidence of relapse and low mortality seen in patients with limited chronic GvHD. DISCUSSION The presence and extent of chronic GvHD is an important predictor of outcome following allogeneic PBSCT, in that patients who developed either limited or extensive chronic GvHD had a low risk of disease relapse.

中文翻译：

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慢性 GvHD 对异基因 PBSC 移植后复发和存活的影响分析

背景 PBSC 越来越多地被用作同种异体移植中的干细胞来源。未经处理的同种异体 PBSC 移植 (PBSCT) 后慢性 GvHD 的发生率增加，然而，这如何影响总体存活率尚不清楚。我们的目的是研究慢性 GvHD 对同种异体 PBSCT 后存活和复发的影响。方法 我们分析了 73 名接受 HLA 匹配的同种异体 PBSCT 患者的数据。97% 的患者使用 CYA 和 MTX 预防 GvHD。我们研究了慢性 GvHD 的发病率及其对这些患者复发和生存的影响。在分析时，所有患者均在移植后至少 100 天。结果 73 名患者可评估慢性 GvHD 的分析。慢性 GvHD 的总发病率为 55%（局限在 18%，广泛在 37%）。总体中位生存期为 991 天，4 年生存率为 48%。12 名患者复发。慢性 GvHD 患者的疾病复发率显着降低（p = 0.005），3 年复发概率为 8%，而没有慢性 GvHD 的患者为 40%。此外，慢性 GvHD 的程度对生存率有显着影响，局限性慢性 GvHD 患者的 4 年生存率为 83%，而广泛慢性 GvHD 患者为 45%，非慢性 GvHD 患者为 38%。这种差异主要是由于在有限慢性 GvHD 患者中观察到的低复发率和低死亡率。