INCIDENCE OF GRAFT-VERSUS-HOST DISEASE IN HONG-KONG CHINESE AND ITS INFLUENCE ON SURVIVAL AFTER BONE-MARROW TRANSPLANTATION FROM HLA-IDENTICAL SIBLINGS

Graft-versus-host disease (GVHD) is an important complication of allog eneic bone marrow transplantation (BMT), To assess its influence on tr ansplant outcome, we studied 90 Chinese patients with hematologic diso rders with BMT from HLA-identical siblings, GVHD) prophylaxis consiste d of a combination of methotrexate (MTX) and cyclosporine A (CsA).The incidence of grade II-IV acute GVHD was 29% (95% CI 19-38%). The incid ence of limited and extensive chronic GVHD was 30% (95% CI 20-40%). Fo r patients transplanted for early hematologic malignancy (n = 40), tho se with GVHD (acute and/or chronic) had lower relapse rate (17% (95% C I 0-36%) vs. 54% (95% CI 26-82%), P = 0.043) They had higher transplan t-related mortality (12% (95% CI 0-28%) vs. 6% (95% CI 0-18%), P = 0.7 15) and event-free survival (EFS) (73% (95% CI 53-93%) vs. 43% (95% CI 17-69%), P = 0.104) that had not reached statistical significance, Fo r patients transplanted for advanced hematologic malignancy (n = 37), those with GVHD also had lower relapse rate (5% (95% CI 0-15%) vs. 72% (95% CI 50-94%), P=0.002) and higher transplant-related mortality (50 % (95% CI 27-73%) vs. 8% (95% CI 0-24%), P = 0.006) than those without any GVHD. They had higher EFS (47% (95% CI 24-70%) vs. 26% (95% CI 5- 47%), P = 0.609) that had not reached statistical significance. Theref ore, the incidence of acute and chronic GVHD in Chinese was similar to that of their Caucasian counterparts using MTX and CsA for GVHD proph ylaxis, Relapse rate was decreased in patients transplanted for hemato logic malignancy for patients transplanted both for advanced and early disease, Overall, GVHD may have a positive effect on survival in pati ents transplanted for hematologic malignancy.