%0 Journal Article %J Blood %D 1999 %T Risk factors for acute graft-versus-host disease after allogeneic blood stem cell transplantation. %A Przepiorka,D. %A Smith,T. L. %A Folloder,J. %A Khouri,I. %A Ueno,NT %A Mehra,R. %A Körbling,M. %A Huh,Y. O. %A Giralt,S. %A Gajewski,J. %A Donato,M. %A Cleary,K. %A Claxton,D. %A Braunschweig,I. %A vanBesien,K. %A Andersson,BS %A Anderlini,P. %A Champlin,R. %K Adolescent %K Adult %K Aged %K Child %K Female %K Graft vs Host Disease %K Hematopoietic Stem Cell Transplantation %K Histocompatibility Testing %K HLA Antigens %K Humans %K Immunosuppressive Agents %K Male %K Middle Aged %K Risk Factors %K Transplantation, Homologous %X We evaluated demographic characteristics and graft composition as risk factors for acute graft-versus-host disease (GVHD) in 160 adult recipients of HLA-identical allogeneic blood stem cell transplants. The patients received a median nucleated cell dose of 7.9 x 10(8)/kg and median C34(+) cell dose of 5.6 x 10(6)/kg. GVHD prophylaxis consisted of cyclosporine (CSA) and steroids, tacrolimus (FK506) and steroids, or FK506 and methotrexate. Grades 2 to 4 GVHD occurred in 31% (95% CI, 23% to 39%), and grades 3 to 4 GVHD in 14% (95% CI, 8% to 20%). In univariate analyses, GVHD prophylaxis with CSA and high CD34(+) cell doses were significant risk factors for grades 2 to 4 GVHD, but diagnosis, age, use of total body irradiation, donor sex, female donor for male recipient, donor parity, donor alloimmunization, viral serology, nucleated cell dose, CD3(+) cell dose, and CD56(+) cell dose did not alter the incidence of GVHD significantly. With a CD34(+) cell dose less than 8 x 10(6) CD34(+) cells/kg, the risk of grades 2 to 4 GVHD was significantly higher for those who received CSA (39%, 95% CI, 21% to 47%) in comparison with those on FK506 (18%, 95% CI, 10% to 26%) (P =.03), but GVHD prophylaxis regimen had less impact with a higher CD34(+) cell dose (overall grades 2 to 4 GVHD rate 52%, 95% CI, 37% to 67%). GVHD prophylaxis and CD34(+) cell dose are independent risk factors for acute GVHD after allogeneic blood stem cell transplantation. %B Blood %V 94 %P 1465 - 70 %8 Aug %G eng %N 4 %M 10438735