Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 19 2 2025 04 20 138 150 EN Naveed Syed Department of Hematology-Oncology, Sheikh Shakbout Medical City, Abu Dhabi, UAE Imrana Afrooz Department of Clinical Research, Sheikh Shakbout Medical City, Abu Dhabi, UAE Farooq Mir Department of Hematology-Oncology, Sheikh Shakbout Medical City, Abu Dhabi, UAE Azmat Khan Department of Hematology-Oncology, Sheikh Shakbout Medical City, Abu Dhabi, UAE Nada Abdulla Mohammed Bin Rashid University of Medical Sciences, Dubai, UAE Shakir Hussain 1)Department of Hematopathology, Sheikh Shakbout Medical City, Abu Dhabi, UAE 2) Gulf Medical University, Ajman, UAE Ashok Chandani Department of Hematology-Oncology, Sheikh Shakbout Medical City, Abu Dhabi, UAE Amera Hassan University of Chicago, Chicago, USA Hanin Samad Rashid Hospital, Dubai, UAE Gehad Ghazali 1) Sheikh Khalifa Medical City, Union71, Pure Health, Abu Dhabi, UAE 2) College of Medicine and Health Sciences, Al Ain, UAE Shahrukh Hashmi 1) Mohammed Bin Zayed University of Artificial Intelligence, Abu Dhabi, UAE 2) Khalifa University, Abu Dhabi, UAE 3) Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA 4) Department of Health, Abu Dhabi, UAE 2024 02 04 2024 08 31 Background: Patients from regions without stem cell transplantation (SCT) facilities often seek treatment abroad and return home for post-transplant care. Although extensive data exist on graft-versus-host disease (GVHD) and its risk factors, information on international SCT patients returning to countries that lack transplant facilities and expertise is scarce and not well documented. Materials and Methods: We screened 149 transplant recipients and analyzed the data of 91 patients who received transplants abroad and were followed up at our center from January 2019 to December 2022. This observational study used data from electronic medical records and employed descriptive statistics, inferential tests, and relative risk calculations with forest plots to analyze the prevalence of GVDH and its key risk factors. Results: Of the recipients, 31.8% were residents of nine countries residing in the UAE, and 67.2% were UAE citizens. Adults comprised 48.3% of the recipients, whereas 51.7% were pediatric patients. Hematological malignancy was the most common indication (49%), primarily in adults. Siblings comprised the majority of donors (52.6%), followed by related (23.09%) and unrelated donors (8.9%). Most patients (69.2%) received HLA-identical transplants, followed by 21.9% who received haplo-identical transplants. Among adults, 62.2% developed GVHD compared to 26% of pediatric patients. Recipients from related HLA-identical donors had a 50% prevalence of GVDH, whereas those from unrelated identical donors had a 71% prevalence. The overall prevalence of GVDH was 50% in 87.9% of patients who received allogeneic SCTs. Conclusion: Despite favorable factors, such as young age and matched related donors, we found a high prevalence of GVDH. Ocular GVHD was less prevalent than expected, and lung GVHD was weakly correlated with established risk factors. Larger multicenter studies are needed to assess and confirm the effect of contributing factors. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/2168 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/2168/1079