Patient, disease, and transplant characteristics: clinical and pathologic correlations
Parameter . | No. of patients (%) . |
|---|---|
| Initial diagnosis | |
| Acute leukemia | 22 (32) |
| Myelodysplastic syndrome | 6 (9) |
| Chronic myelogenous leukemia | 26 (38) |
| Aplastic anemia | 10 (15) |
| Lymphoma | 4 (6) |
| Donor type | |
| HLA-identical sibling donor | 47 (69) |
| Mismatched related donor | 2 (3) |
| Unrelated donor | 19 (28) |
| Conditioning regimen | |
| Including total body irradiation | 38 (56) |
| Without total body irradiation | 30 (44) |
| Graft-versus-host disease prophylaxis | |
| Including cyclosporine | 66 (98) |
| Cyclosporine and methotrexate | 52 (78) |
| Source of transplanted cells | |
| Bone marrow | 48 (70) |
| Peripheral stem cells | 14 (21) |
| Cord blood | 6 (9) |
| Digestive graft-versus-host disease | |
| Stages 0-1 | 49 (72) |
| Stage 2 or more | 19 (28) |
| Pathologic grade | |
| Grade 0 | 18 (26) |
| Grade 1 | 22 (32) |
| Grade 2 | 15 (22) |
| Grade 3* | 10 (15) |
| Grade 4* | 3 (4) |
| More than 20 cells per field expressing TNF-α, according to pathologic grade† | |
| Patients with grades 3-4 | 10/13 (77) |
| Patients with grade 2 | 3/15 (20) |
| More than 5 apoptotic cells per field, within the cellular infiltrate, according to pathologic grade† | |
| Patients with grades 3-4 | 3/13 (23) |
| Patients with grade 2 | 1/15 (7) |
| More than 10 apoptotic epithelial cells per field, according to pathologic grade† | |
| Patients with grades 3-4 | 12/13 (92) |
| Patients with grade 2 | 7/15 (47) |
Parameter . | No. of patients (%) . |
|---|---|
| Initial diagnosis | |
| Acute leukemia | 22 (32) |
| Myelodysplastic syndrome | 6 (9) |
| Chronic myelogenous leukemia | 26 (38) |
| Aplastic anemia | 10 (15) |
| Lymphoma | 4 (6) |
| Donor type | |
| HLA-identical sibling donor | 47 (69) |
| Mismatched related donor | 2 (3) |
| Unrelated donor | 19 (28) |
| Conditioning regimen | |
| Including total body irradiation | 38 (56) |
| Without total body irradiation | 30 (44) |
| Graft-versus-host disease prophylaxis | |
| Including cyclosporine | 66 (98) |
| Cyclosporine and methotrexate | 52 (78) |
| Source of transplanted cells | |
| Bone marrow | 48 (70) |
| Peripheral stem cells | 14 (21) |
| Cord blood | 6 (9) |
| Digestive graft-versus-host disease | |
| Stages 0-1 | 49 (72) |
| Stage 2 or more | 19 (28) |
| Pathologic grade | |
| Grade 0 | 18 (26) |
| Grade 1 | 22 (32) |
| Grade 2 | 15 (22) |
| Grade 3* | 10 (15) |
| Grade 4* | 3 (4) |
| More than 20 cells per field expressing TNF-α, according to pathologic grade† | |
| Patients with grades 3-4 | 10/13 (77) |
| Patients with grade 2 | 3/15 (20) |
| More than 5 apoptotic cells per field, within the cellular infiltrate, according to pathologic grade† | |
| Patients with grades 3-4 | 3/13 (23) |
| Patients with grade 2 | 1/15 (7) |
| More than 10 apoptotic epithelial cells per field, according to pathologic grade† | |
| Patients with grades 3-4 | 12/13 (92) |
| Patients with grade 2 | 7/15 (47) |
In patients with pathologic grades 3-4 (n = 13), there were major changes (including ulceration of the mucosal) in 4 (33%) and minor changes such as edematous mucosal in 5 (41%).
According to a severity index described in Socie et al,20 both TNF expression and number of apoptotic epithelial cells correlated with grades 3-4 pathologic grade and thus with endothelial damages (P < .01).