Chronic graft-versus-host disease in children and adolescents with thalassemia after hematopoietic stem cell transplantation
Data on chronic graft-versus-host disease (cGVHD) in patients with thalassemia after hematopoietic stem cell transplantation (HSCT) have not been specifically explored. The present study aimed to determine the incidence and clinical manifestations of cGVHD in children and adolescents with thalassemi...
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th-mahidol.783352022-08-04T16:28:12Z Chronic graft-versus-host disease in children and adolescents with thalassemia after hematopoietic stem cell transplantation Oranooj Lertkovit Usanarat Anurathapan Suradej Hongeng Nintita Sripaiboonkit Thokanit Samart Pakakasama Faculty of Medicine Ramathibodi Hospital, Mahidol University Medicine Data on chronic graft-versus-host disease (cGVHD) in patients with thalassemia after hematopoietic stem cell transplantation (HSCT) have not been specifically explored. The present study aimed to determine the incidence and clinical manifestations of cGVHD in children and adolescents with thalassemia who underwent HSCT and to compare healthcare utilization and medical cost between patients with and without cGVHD. We retrospectively analyzed the presentations, treatments, and outcomes of historical cGVHD (Seattle criteria), post-transplant admissions and direct medical cost for HSCT patients (n = 66). We used the 2014 NIH consensus criteria to reclassify the diagnosis of cGVHD (NIH cGVHD). Among 28 historical cGVHD patients, 13 (46.4%) fulfilled the NIH criteria. Reasons why the NIH criteria were unmet were reclassification as late acute GVHD and presence of distinctive signs without confirmatory tests. At 2 years after HSCT, the cumulative incidence of NIH cGVHD was 21.67% (95% CI, 12.31–32.74%). Lung cGVHD was associated with inferior survival with a hazard ratio of 13.6 (95% CI, 1.42–131.48). Patients with historical cGVHD had significantly increased frequency of inpatient admissions and medical cost. In conclusion, cGVHD was common in children with thalassemia receiving HSCT. Patients with cGVHD required prolonged immunosuppressive treatment and incurred high medical expenses. 2022-08-04T09:28:12Z 2022-08-04T09:28:12Z 2021-04-01 Article International Journal of Hematology. Vol.113, No.4 (2021), 556-565 10.1007/s12185-020-03055-w 18653774 09255710 2-s2.0-85098480882 https://repository.li.mahidol.ac.th/handle/123456789/78335 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85098480882&origin=inward |
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Medicine Oranooj Lertkovit Usanarat Anurathapan Suradej Hongeng Nintita Sripaiboonkit Thokanit Samart Pakakasama Chronic graft-versus-host disease in children and adolescents with thalassemia after hematopoietic stem cell transplantation |
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Data on chronic graft-versus-host disease (cGVHD) in patients with thalassemia after hematopoietic stem cell transplantation (HSCT) have not been specifically explored. The present study aimed to determine the incidence and clinical manifestations of cGVHD in children and adolescents with thalassemia who underwent HSCT and to compare healthcare utilization and medical cost between patients with and without cGVHD. We retrospectively analyzed the presentations, treatments, and outcomes of historical cGVHD (Seattle criteria), post-transplant admissions and direct medical cost for HSCT patients (n = 66). We used the 2014 NIH consensus criteria to reclassify the diagnosis of cGVHD (NIH cGVHD). Among 28 historical cGVHD patients, 13 (46.4%) fulfilled the NIH criteria. Reasons why the NIH criteria were unmet were reclassification as late acute GVHD and presence of distinctive signs without confirmatory tests. At 2 years after HSCT, the cumulative incidence of NIH cGVHD was 21.67% (95% CI, 12.31–32.74%). Lung cGVHD was associated with inferior survival with a hazard ratio of 13.6 (95% CI, 1.42–131.48). Patients with historical cGVHD had significantly increased frequency of inpatient admissions and medical cost. In conclusion, cGVHD was common in children with thalassemia receiving HSCT. Patients with cGVHD required prolonged immunosuppressive treatment and incurred high medical expenses. |
author2 |
Faculty of Medicine Ramathibodi Hospital, Mahidol University |
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Faculty of Medicine Ramathibodi Hospital, Mahidol University Oranooj Lertkovit Usanarat Anurathapan Suradej Hongeng Nintita Sripaiboonkit Thokanit Samart Pakakasama |
format |
Article |
author |
Oranooj Lertkovit Usanarat Anurathapan Suradej Hongeng Nintita Sripaiboonkit Thokanit Samart Pakakasama |
author_sort |
Oranooj Lertkovit |
title |
Chronic graft-versus-host disease in children and adolescents with thalassemia after hematopoietic stem cell transplantation |
title_short |
Chronic graft-versus-host disease in children and adolescents with thalassemia after hematopoietic stem cell transplantation |
title_full |
Chronic graft-versus-host disease in children and adolescents with thalassemia after hematopoietic stem cell transplantation |
title_fullStr |
Chronic graft-versus-host disease in children and adolescents with thalassemia after hematopoietic stem cell transplantation |
title_full_unstemmed |
Chronic graft-versus-host disease in children and adolescents with thalassemia after hematopoietic stem cell transplantation |
title_sort |
chronic graft-versus-host disease in children and adolescents with thalassemia after hematopoietic stem cell transplantation |
publishDate |
2022 |
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https://repository.li.mahidol.ac.th/handle/123456789/78335 |
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1763488288588431360 |