Retrospective evaluation of acute graft versus host disease and chronic graft versus host disease in patients with allogeneic hematopoietic stem cell transplantation

Developments in infection prophylaxis, immunosuppressive strategies, DNA-based tissue typing and supportive care measures along with allogeneic hematopoietic stem cell transplantation (Allo-HSCT) have resulted in significant disease control and cure success rate. Graft Versus Host Disease (GVHD) is one of the most serious complications of morbidity and mortality after Allo-HSCT. The aim of this observational study is; to research incidence of GVHD after transplantation in Allo-HSCT patients, to identify to risk factors for the development of acute GVHD (aGVHD) and chronic GVHD (crGVHD), to determine the rate of mortality and morbidity associated with GVHD. In this study 162 patients were evaluated restrospectively in terms of GVHD, who underwent Allo-HSCT between January 2013 and May 2019 in two Adult Bone Marrow Transplantation Centers affiliated with Adnan Menderes University Hospital and Private City Hospital respectively. Laboratory examinations, pathology and epicrisis reports of the patients were obtained from the hospital automation system and recorded files at the hospital. The diagnosis of GVHD was found in 54.3% of the patients who underwent Allo-HSCT, the majority of which were acute leukemia. GVHD type and grade were found to affect survival. In terms of survival time, AML was the most affected diagnosis from GVHD type. A significant correlation was found between the positivity of CMV-reactivation and GVHD type. The most commonly affected organ from GVHD was skin. Infection was the most common cause of death, while the proportion of patients who died of GVHD was 3.06%. As a result of this study, it has been shown that GVHD type and grade and CMV reactivation significantly reduce survival. Besides, the degree of aGVHD was found to significantly reduce the survival rate of patients with AML.