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ISSN 2063-5346
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GRAFT-VERSUS-HOST DISEASE IN PEDIATRIC PATIENTS UNDERGOING ALLOGENIC HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR BENIGN DISORDERS (A SINGLE CENTER STUDY)

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Mona Hassan Eltagui, Khaled Salama, Ahmed M Kaddah, Monica Ashraf Nashed, Mai Abd EL Salam
» doi: 10.31838/ecb/2023.12.s1-B.207

Abstract

Background: Despite great advances in hematopoietic stem cell transplantation (HSCT) procedure, posttransplant complications -especially after allogenic transplant (allo-HSCT) - remain a great challenge. Graft versus host disease (GVHD) is the most important complication following allo-HSCT. Objective: To evaluate the post-transplant GVHD in pediatric patients undergoing allo-HSCT for benign conditions. Methods: The study included 36 pediatric patients, with benign hematological or immunological disorders, who underwent allo-HSCT in Hematology and Bone Marrow Transplantation Unit - Cairo University Children Hospital (2014-2020). Transplant-related data were recorded. Data regarding GVHD incidence, characteristics, management and outcome were collected. Results: GVHD occurred in 58.3% of patients, with early onset GVHD in 47.2% while late GVHD in 36.1%; 9 patients developed both early and late GVHD (25%). Cutaneous GVHD occurred in 95.2% of GVHD patients while gut and hepatic involvement occurred in 19% and 14.3% respectively. Regarding acute GVHD cases, Grades I, II, III and IV occurred in 41.2%, 23.5%, 29.4% and 5.9% respectively. As for chronic GVHD cases, 53.8% developed mild disease while 30.8% developed severe disease. and only 15.4% had moderate affection. GVHD completely resolved in 12 patients (57.1%), 3 patients (14.3%) had residual stationary lesions not requiring treatment and 6 cases (28.6%) had controlled disease on immunosuppression. Conclusion: Although GVHD is a common complication post allo-HSCT, especially when using Peripheral blood stem cells, prognosis with current treatment modalities is relatively good. Skin GVHD represents the most common form of GVHD followed by gut GVHD then hepatic GVHD.

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