Results:
Among 183 patients evaluable for GVHD, acute GVHD (aGVHD) grades I, II,
III, and IV were present in 18%, 12.6%, 3.8% and 5.5% of patients,
respectively. Limited and extensive chronic GVHD (cGVHD), were observed
in 8.7% and 12.6% of patients. Patients with aGVHD grade III/IV had
significantly lower 3-year survival rates than those without aGVHD, or
those with aGVHD grade I/II (52.9% [95% confidence interval (CI)
34-83] vs. 90.1% [95% CI 84-96], vs. 98.1% [95%CI 95-100],
p<0.001). Patients without cGVHD and those with limited and
extensive cGVHD had 3-year survival rates of 88.9% [95%CI 84-94],
91.7% [95%CI 77-100], and 84.8% [95%CI 70-100],
respectively, log rank p =0.3. Receiving transplant from an
HLA-mismatched unrelated donor (MMUD), as compared to a matched related
donor (MRD), increased the risk for aGVHD grade III/IV (Odds ratio 10.4
[95% CI 2.5-47.6]). There were no cases of aGVHD grade III/IV among
recipients of mismatched related/haploidentical transplants.