ALLOGENEIC PERIPHERAL-BLOOD STEM-CELL TRANSPLANTATION MAY BE ASSOCIATED WITH A HIGH-RISK OF CHRONIC GRAFT-VERSUS-HOST DISEASE

Chronic graft-versus-host disease (GVHD) is likely caused by donor T l ymphocytes. Because unmodified blood stem cell grafts contain one log more T lymphocytes than unmodified marrow grafts, we evaluated the inc idence of chronic GVHD in previously reported 37 blood stem cell recip ients and 37 computer-matched historical control marrow recipients (Be nsinger et al, Blood 88:2794, 1996). AII patients have been followed u ntil death, relapse, or occurrence of chronic GVHD or for a minimum of 2 years. In a univariable proportional hazards regression model, the relative risk of developing clinical chronic GVHD (includes clinical l imited and clinical extensive disease) by 2 years posttransplant among the peripheral blood stem cell recipients compared with the marrow re cipients was 2.22 (95% confidence interval, 1.04 to 4.74; P =.039). Fo r clinical extensive chronic GVHD, the relative risk was 2.37 (95% con fidence interval, 1.07 to 5.29; P =.035). In multivariable analyses, c onsidering also the covariables of patient age, patient cytomegaloviru s serostatus, and donor cytomegalovirus serostatus, the relative risks of clinical chronic GVHD and clinical extensive chronic GVHD were als o greater than 2 (P <.05). We conclude that the transplantation of unm anipulated filgrastim-mobilized blood stem cells may result in a relat ively high incidence of chronic GVHD. (C) 1997 by The American Society of Hematology.