The impact of acute and chronic graft-versus-host disease (GVHD) on clinical outcomes was retrospectively analyzed in 960 patients with non-malignant diseases (NMD) who underwent a first allogeneic hematopoietic stem cell transplantation (HSCT). Grade III-IV acute GVHD (but not grade I-II) was significantly associated with a lower rate of overall survival (OS), and higher non-relapse mortality (NRM) than that seen in patients without acute GVHD. Extensive (but not limited) GVHD was significantly associated with a lower OS rate and higher NRM than that seen in patients without chronic GVHD. Any grade of acute (but not chronic) GVHD was significantly associated with a lower incidence of relapse and a lower proportion of patients requiring a second HSCT or donor lymphocyte infusion for graft failure or mixed chimerism, but its impact on OS was almost negligible. Acute GVHD was significantly associated with lower OS rates in all disease groups, whereas chronic GVHD was significantly associated with lower OS rates in the primary immunodeficiency and histiocytosis groups. In conclusion, acute and chronic GVHD, even if mild, was associated with reduced OS in patients receiving HSCT for NMD and effective strategies should, therefore, be implemented to minimize GVHD.

中文翻译：

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移植物抗宿主病对非恶性疾病同种异体造血干细胞移植临床结果的影响。

回顾性分析了960例接受首次异基因造血干细胞移植（HSCT）的非恶性疾病（NMD）患者的急性和慢性移植物抗宿主病（GVHD）对临床结局的影响。与没有急性GVHD的患者相比，III-IV级急性GVHD（而非I-II级）与较低的总体存活率（OS）和较高的非复发死亡率（NRM）显着相关。与没有慢性GVHD的患者相比，广泛的（但不限于）GVHD与较低的OS率和较高的NRM显着相关。任何级别的急性（但非慢性）GVHD均与复发率降低和因移植失败或混合嵌合体而需要第二次HSCT或供体淋巴细胞输注的患者比例降低显着相关，但是它对操作系统的影响几乎可以忽略不计。在所有疾病组中，急性GVHD与较低的OS率显着相关，而在原发性免疫缺陷和组织细胞增生组中，慢性GVHD与较低的OS率显着相关。总之，急性和慢性GVHD，即使是轻度的，也与接受HSCT接受NMD的患者的OS降低有关，因此，应采取有效策略以最小化GVHD。