CLINICAL FEATURES OF GRAFT-VERSUS-HOST DISEASE IN PATIENTS WITH APLASTIC ANAEMIA FOLLOWING HAEMATOPOIETIC STEM CELL TRANSPLANTATION

Аннотация

Graft-versus-host disease (GVHD) remains one of the most serious and frequent complications following allogeneic haematopoietic stem cell transplantation (allo-HSCT), particularly in patients with acute leukaemia. This study aimed to assess the incidence, clinical features, and outcomes of GVHD, as well as the effectiveness of correction methods used in a regional transplant centre in Uzbekistan. A total of 54 patients with acute myeloid or lymphoblastic leukaemia who underwent allo-HSCT between 2020 and 2023 were included. GVHD developed in 53.7% of cases, with acute GVHD occurring in 38.9% and chronic GVHD in 14.8%. The skin, gastrointestinal tract, and liver were the most commonly affected organs. Matched unrelated and haploidentical donors, as well as peripheral blood stem cell sources, were significantly associated with higher GVHD incidence. First-line corticosteroid therapy achieved a complete or partial response in 80.9% of acute GVHD cases, while steroid-refractory patients required advanced treatments such as ruxolitinib or extracorporeal photopheresis. GVHD-related mortality was 9.3%, with sepsis being the leading cause of death. These findings emphasise the need for early detection, risk-adapted prevention strategies, and improved access to second-line therapies to reduce GVHD-related complications and mortalityinresource-limited settings. Keywords: Graft-versus-host disease, allogeneic transplantation, acute leukaemia, stem cell transplant, corticosteroids, ruxolitinib, immunosuppression, Uzbekistan, transplant complications.