Chronic liver graft-versus-host disease in allogeneic hematopoietic stem cell transplantation recipients during tapering or after stopping calcineurin inhibitors

被引：2

作者：

Yoshimura, Kazuki ^{[1
]}

Kimura, Shun-Ichi ^{[1
]}

Kawamura, Masakatsu ^{[1
]}

Kawamura, Shunto ^{[1
]}

Takeshita, Junko ^{[1
]}

Yoshino, Nozomu ^{[1
]}

Misaki, Yukiko ^{[1
]}

Gomyo, Ayumi ^{[1
]}

Matsumi, Shimpei ^{[1
]}

Akahoshi, Yu ^{[1
]}

Tamaki, Masaharu ^{[1
]}

Kusuda, Machiko ^{[1
]}

Kameda, Kazuaki ^{[1
]}

Wada, Hidenori ^{[1
]}

Kawamura, Koji ^{[1
]}

Sato, Miki ^{[1
]}

Terasako-Saito, Kiriko ^{[1
]}

Tanihara, Aki ^{[1
]}

Nakasone, Hideki ^{[1
]}

Kako, Shinichi ^{[1
]}

Kanda, Yoshinobu ^{[1
]}

机构：

[1] Jichi Med Univ, Div Hematol, Saitama Med Ctr, Omiya Ku, 1-847 Amanuma, Saitama, Saitama 3308503, Japan

来源：

INTERNATIONAL JOURNAL OF HEMATOLOGY | 2021年 / 114卷 / 06期

关键词：

Graft-versus host disease; Liver; Calcineurin inhibitor; Hematopoietic stem cell transplantation; RISK-FACTORS; BONE-MARROW; DIAGNOSIS; HEPATITIS; SEROLOGY; CRITERIA; DONORS;

D O I：

10.1007/s12185-021-03202-x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：674 / 681

页数：8

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