Chronic graft-versus-host disease in children and adolescents with thalassemia after hematopoietic stem cell transplantation.
Adolescent
Biopsy
Child
Child, Preschool
Chronic Disease
Female
Graft vs Host Disease
/ diagnosis
Health Care Costs
Health Care Surveys
Hematopoietic Stem Cell Transplantation
/ adverse effects
Humans
Immunosuppressive Agents
/ adverse effects
Male
Organ Specificity
Patient Acceptance of Health Care
Prognosis
Thailand
/ epidemiology
Thalassemia
/ complications
Tissue Donors
Transplantation Conditioning
/ adverse effects
Treatment Outcome
Chronic graft-versus-host disease
Hematopoietic stem cell transplantation
NIH criteria
Thalassemia
Journal
International journal of hematology
ISSN: 1865-3774
Titre abrégé: Int J Hematol
Pays: Japan
ID NLM: 9111627
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
10
08
2020
accepted:
02
12
2020
revised:
01
12
2020
pubmed:
2
1
2021
medline:
22
6
2021
entrez:
1
1
2021
Statut:
ppublish
Résumé
Data on chronic graft-versus-host disease (cGVHD) in patients with thalassemia after hematopoietic stem cell transplantation (HSCT) have not been specifically explored. The present study aimed to determine the incidence and clinical manifestations of cGVHD in children and adolescents with thalassemia who underwent HSCT and to compare healthcare utilization and medical cost between patients with and without cGVHD. We retrospectively analyzed the presentations, treatments, and outcomes of historical cGVHD (Seattle criteria), post-transplant admissions and direct medical cost for HSCT patients (n = 66). We used the 2014 NIH consensus criteria to reclassify the diagnosis of cGVHD (NIH cGVHD). Among 28 historical cGVHD patients, 13 (46.4%) fulfilled the NIH criteria. Reasons why the NIH criteria were unmet were reclassification as late acute GVHD and presence of distinctive signs without confirmatory tests. At 2 years after HSCT, the cumulative incidence of NIH cGVHD was 21.67% (95% CI, 12.31-32.74%). Lung cGVHD was associated with inferior survival with a hazard ratio of 13.6 (95% CI, 1.42-131.48). Patients with historical cGVHD had significantly increased frequency of inpatient admissions and medical cost. In conclusion, cGVHD was common in children with thalassemia receiving HSCT. Patients with cGVHD required prolonged immunosuppressive treatment and incurred high medical expenses.
Identifiants
pubmed: 33385291
doi: 10.1007/s12185-020-03055-w
pii: 10.1007/s12185-020-03055-w
doi:
Substances chimiques
Immunosuppressive Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
556-565Références
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