Prediction of Graft versus Host Disease

To the Editor: The article by Vogelsang et al. (September 12 issue)¹ contains interesting data regarding an in vitro test to predict clinical graft versus host disease (GVHD). It would appear, however, that this test may not be useful in patients receiving cyclosporine as prophylaxis against the disease. It is unfortunate that this test was applied in a tremendously heterogeneous group of patients. The ages, diagnoses, conditioning regimens, and most important, the prophylactic regimens were not uniform. The Johns Hopkins group has previously reported that the risk of GVHD was increased in patients with acute lymphocytic leukemia or sex-mismatched grafts.