T-cell depletion with alemtuzumab represents an effective form of graft-versus-host disease (GVHD) prophylaxis after allogeneic haematopoietic stem cell transplantation (allo-HSCT); however, little is known regarding the impact of in vivo alemtuzumab on either the incidence or clinical characteristics of acute and chronic GVHD. We therefore studied 201 consecutive adult patients who received an alemtuzumab-based, reduced-intensity conditioned (RIC) allograft. With a median follow-up of 24 months, the cumulative incidence of classic acute and late acute (persistent, recurrent and late onset) GVHD grades II-IV (grades III-IV) was 34% (13%) and 20% (8%) respectively; the cumulative incidence of classic chronic GVHD and overlap syndrome were 4% and 7% respectively. A previous diagnosis of classic acute GVHD is a risk factor for chronic GVHD (hazard ratio 10·91, 95% confidence interval 2·35-50·63, P = 0·0023) while late onset acute GVHD is not a risk factor for later development of chronic GVHD. Unrelated donor transplant is a risk factor for the development of classic acute GVHD but not for late onset or chronic GVHD. In conclusion, this study describes a distinctive pattern of GVHD following alemtuzumab-RIC allografts, identifies the risk factors for GVHD development and provides prognostic information of patients with GVHD.

中文翻译：

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含阿仑单抗的同种异体干细胞移植后发生的移植物抗宿主病特征：发生率，器官受累，危险因素和存活率。

异体造血干细胞移植（allo-HSCT）后，用阿仑单抗清除T细胞是预防移植物抗宿主病（GVHD）的有效形式。然而，关于体内阿仑单抗对急性和慢性GVHD的发生率或临床特征的影响知之甚少。因此，我们研究了201位连续的成人患者，这些患者接受了基于alemtuzumab的降低强度条件（RIC）同种异体移植。中位随访期为24个月，经典急性和晚期急性（持续，反复发作和晚期发作）GVHD II-IV级（III-IV级）的累积发生率分别为34％（13％）和20％（8 ％） 分别; 经典慢性GVHD和重叠综合征的累积发生率分别为4％和7％。先前对经典急性GVHD的诊断是慢性GVHD的危险因素（危险比10·91，95％置信区间2·35-50·63，P = 0·0023），而迟发的急性GVHD并非慢性GVHD的危险因素。后来发展为慢性GVHD。不相关的供体移植是发生经典急性GVHD的危险因素，但对于迟发性或慢性GVHD则不是危险因素。总之，本研究描述了阿仑单抗-RIC同种异体移植后GVHD的独特模式，确定了GVHD发生的危险因素，并提供了GVHD患者的预后信息。