TY - JOUR T1 - Risk factors for acute graft-versus-host disease after allogeneic blood stem cell transplantation. JF - Blood Y1 - 1999 A1 - Przepiorka,D. A1 - Smith,T. L. A1 - Folloder,J. A1 - Khouri,I. A1 - Ueno,NT A1 - Mehra,R. A1 - Körbling,M. A1 - Huh,Y. O. A1 - Giralt,S. A1 - Gajewski,J. A1 - Donato,M. A1 - Cleary,K. A1 - Claxton,D. A1 - Braunschweig,I. A1 - vanBesien,K. A1 - Andersson,BS A1 - Anderlini,P. A1 - Champlin,R. KW - Adolescent KW - Adult KW - Aged KW - Child KW - Female KW - Graft vs Host Disease KW - Hematopoietic Stem Cell Transplantation KW - Histocompatibility Testing KW - HLA Antigens KW - Humans KW - Immunosuppressive Agents KW - Male KW - Middle Aged KW - Risk Factors KW - Transplantation, Homologous AB - We evaluated demographic characteristics and graft composition as risk factors for acute graft-versus-host disease (GVHD) in 160 adult recipients of HLA-identical allogeneic blood stem cell transplants. The patients received a median nucleated cell dose of 7.9 x 10(8)/kg and median C34(+) cell dose of 5.6 x 10(6)/kg. GVHD prophylaxis consisted of cyclosporine (CSA) and steroids, tacrolimus (FK506) and steroids, or FK506 and methotrexate. Grades 2 to 4 GVHD occurred in 31% (95% CI, 23% to 39%), and grades 3 to 4 GVHD in 14% (95% CI, 8% to 20%). In univariate analyses, GVHD prophylaxis with CSA and high CD34(+) cell doses were significant risk factors for grades 2 to 4 GVHD, but diagnosis, age, use of total body irradiation, donor sex, female donor for male recipient, donor parity, donor alloimmunization, viral serology, nucleated cell dose, CD3(+) cell dose, and CD56(+) cell dose did not alter the incidence of GVHD significantly. With a CD34(+) cell dose less than 8 x 10(6) CD34(+) cells/kg, the risk of grades 2 to 4 GVHD was significantly higher for those who received CSA (39%, 95% CI, 21% to 47%) in comparison with those on FK506 (18%, 95% CI, 10% to 26%) (P =.03), but GVHD prophylaxis regimen had less impact with a higher CD34(+) cell dose (overall grades 2 to 4 GVHD rate 52%, 95% CI, 37% to 67%). GVHD prophylaxis and CD34(+) cell dose are independent risk factors for acute GVHD after allogeneic blood stem cell transplantation. VL - 94 CP - 4 ID - 1288 ER -