FREQUENCY AND OUTCOME OF ACUTE GRAFT VERSUS HOST DISEASE AFTER ALLOGENEIC STEM CELL TRANSPLANTATION IN TERTIARY CARE HOSPITAL OF PAKISTAN

Abstract

Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative therapy for various hematological and non-malignant disorders; however, acute graft-versus-host disease (aGVHD) remains a major complication influencing post-transplant outcomes.

Objective: To identify the incidence, severity of aGVHD and the outcome of allo-HSCT early after the procedure in patients receiving allo-HSCT in a tertiary care centre.

Methods: This is a descriptive observational study, which is conducted at Department of Clinical Hematology, Shifa International Hospital, Islamabad for 6 months from July 2025 to January 2026. In total, 100 patients were enrolled based on WHO sample size calculation with expected prevalence of aGVHD of 42%, a precision of 10% and a 95% confidence level. Fully matched or haploidentical donors were used for patients. aGVHD was diagnosed and graded on the basis of modified Glucksberg criteria within 100 days after transplant. Analysis of data was carried out using SPSS 26 using chi-square and Kaplan–Meier survival analysis.

Results: Overall, 100 patients who underwent allo-HSCT were studied. Mean age was 32.4 ± 14.6 years; 52% had malignant and 40% benign disorders. The fully matched donors were 72% and haploidentical donors 20%. Twenty-seven percent developed acute GVHD with the most common severity being gastrointestinal (15%), followed by skin (8%), oral cavity (3%), and lung (1%). There was significantly poorer survival in the haploidentical transplants (log-rank p = 0.03).

Conclusion: aGVHD continues to be a common and clinically important complication of allo-HSCT, and a major cause of early mortality.