Acute GVHD after allogeneic hematopoietic transplantation affects early marrow reconstitution and speed of engraftment

Our aim was to study the influence of acute graft-versus-host disease (a-GVHD) on primary engraftment times after allogeneic transplantation. Primary engraftment and frequency of marrow granulocyte-macrophage colony-forming units and erythroid burstforming units, at day +18, were studied in 126 allogeneic transplants. Patients were grouped according to the time when a-GVHD treatment with corticosteroids was started. The no a-GVHD group are those who, during the first 3 months, had no need for a-GVHD treatment; the early a-GVHD group are those who needed a-GVHD treatment within 19 days; and the postengraftment a-GVHD group are those who were not on corticosteroid treatment at the time of engraftment but needed it after day +19. The no a-GVHD group reached a neutrophil count (N) > 0.5 x 10(9)/L in a median of 17.8 days. The postengraftment a-GVHD group reached N> 0.5 x 10(9/)L in a median of 21.4 days (p = 0.0003). The early a-GVHD group had N > 0.5 x 10(9)/L in a median of +17.0 days (p = 0.23). When factors important for engraftment were studied in a multivariate analysis, postengraftment a-GVHD was a significant factor in delayed neutrophil and platelet engraftment. Both the early a-GVHD and postengraftment a-GVHD groups showed a significant reduction in frequency of granulocyte-macrophage colony-forming units and erythroid burst-forming units found in marrow at day +18. In conclusion, a-GVHD may influence early marrow reconstitution and is a relevant factor for primary myeloid and platelet engraftment. Copyright (C) 2015 ISEH - International Society for Experimental Hematology. Published by Elsevier Inc.