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Stem Cells International
Volume 2016, Article ID 5143071, 9 pages
http://dx.doi.org/10.1155/2016/5143071
Research Article

Prognostic Factors on the Graft-versus-Host Disease-Free and Relapse-Free Survival after Adult Allogeneic Hematopoietic Stem Cell Transplantation

1Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
2Faculty of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
3Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taitung Branch, Taitung City, Taitung County 95059, Taiwan
4Institute of Clinical Medicine, National Yang-Ming University, Taipei 11221, Taiwan
5Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
6Department of Medicine, Cardinal Tien Hospital, New Taipei City 23148, Taiwan

Received 2 December 2015; Revised 12 February 2016; Accepted 25 February 2016

Academic Editor: Jenny Persson

Copyright © 2016 Yao-Chung Liu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The cure of hematologic disorders by allogeneic hematopoietic stem cell transplantation (HSCT) is often associated with major complications resulting in poor outcome, including graft-versus-host disease (GVHD), relapse, and death. A novel composite endpoint of GVHD-free/relapse-free survival (GRFS) in which events include grades 3-4 acute GVHD, chronic GVHD requiring systemic therapy, relapse, or death is censored to completely characterize the survival without mortality or ongoing morbidity. In this regard, studies attempting to identify the prognostic factors of GRFS are quite scarce. Thus, we reviewed 377 adult patients undergoing allogeneic HSCT between 2003 and 2013. The 1- and 2-year GRFS were 40.8% and 36.5%, respectively, significantly worse than overall survival and disease-free survival (log-rank ). European Group for Blood and Marrow Transplantation (EBMT) risk score > 2 () and hematologic malignancy () were poor prognostic factors for 1-year GRFS. For 2-year GRFS, EBMT risk score > 2 (), being male (), and hematologic malignancy () were significant for poor outcome. The events between 1-year GRFS and 2-year GRFS predominantly increased in relapsed patients. With prognostic factors of GRFS, we could evaluate the probability of real recovery following HSCT without ongoing morbidity.