Chronic liver graft-versus-host disease in allogeneic hematopoietic stem cell transplantation recipients during tapering or after stopping calcineurin inhibitors.
Adolescent
Adult
Aged
Calcineurin Inhibitors
/ administration & dosage
Chronic Disease
Disease Management
Disease Susceptibility
Drug Tapering
Female
Graft vs Host Disease
/ diagnosis
Hematopoietic Stem Cell Transplantation
/ adverse effects
Humans
Liver Diseases
/ diagnosis
Male
Middle Aged
Retrospective Studies
Risk Factors
Transplant Recipients
Transplantation, Homologous
Treatment Outcome
Young Adult
Calcineurin inhibitor
Graft-versus host disease
Hematopoietic stem cell transplantation
Liver
Journal
International journal of hematology
ISSN: 1865-3774
Titre abrégé: Int J Hematol
Pays: Japan
ID NLM: 9111627
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
31
03
2021
accepted:
02
08
2021
revised:
02
08
2021
pubmed:
12
8
2021
medline:
17
12
2021
entrez:
11
8
2021
Statut:
ppublish
Résumé
Chronic graft-versus-host disease (cGVHD) of the liver is often observed in allogeneic hematopoietic stem cell transplantation (allo-HSCT) during tapering or after stopping calcineurin inhibitors (CI). We conducted a retrospective analysis of 242 allo-HSCT recipients whose CI dose was reduced to less than 40 mg of cyclosporin A or 0.4 mg of tacrolimus to clarify the clinical characteristics of liver GVHD in patients on low-dose CI. Sixty patients (25%) developed clinically suspected liver cGVHD while on low-dose CI. Multivariate analysis showed that donor age ≥ 40 years [hazard ratio (HR) 2.20], myeloablative conditioning (HR 2.19), female donor to male recipient (HR 2.53) and recipient seropositivity for herpes simplex virus (HR 2.52) were significant risk factors for liver cGVHD during low-dose CI period. Peak aspartate aminotransferase and alanine aminotransferase levels were higher in patients with liver GVHD during low-dose CI period than in other periods. Twenty-seven patients were initially treated with resumption of CI or a CI dose increase and 21 responded. Among the 18 patients treated with corticosteroids, total bilirubin was a risk factor for failure of corticosteroid therapy. The results of this study clarified the clinical characteristics of liver GVHD in patients on low-dose CIs.
Identifiants
pubmed: 34378178
doi: 10.1007/s12185-021-03202-x
pii: 10.1007/s12185-021-03202-x
doi:
Substances chimiques
Calcineurin Inhibitors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
674-681Informations de copyright
© 2021. Japanese Society of Hematology.
Références
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