[DanL]

I am missing my resource here, but seem to recall that about 80% of the relapse and TRM are going to happen within the first year after transplant, with 95% happening within 2 years, which may be why the statistics aren't really available beyond 1 year. I reviewed a couple of charts which seemed to confirm that I was on the right track here.

The T-Cell depletion is still considered a bit of a controversy in the medical community as the gain in GVHD reduction is offset by the GVL effect reduction.

As Whizbang noted, the identification of the ST1 or ST2 protein seems to be an important development, and may be worth asking your transplant doctor about. Increases in this protein have been correlated as an early predictor of GVHD and may allow your transplant team to take a stronger, more proactive approach to fighting GVHD. I just don't know how widespread or available the testing is for this just yet, but it is a great question to ask.

As with most matters related to bone marrow failure, it is really important to have a good team of doctors that you trust, and to feel free to seek second opinons, or third opinions until you are comfortable with the process, and the ability to seek additional treatment options if needed.

The doctors that I have spoken to generally agree that a little bit of GVHD is not a bad thing, but also that it is very important to avoid the grade III and IV if possible, so catching it early is key to managing it effectively.