Koh et al. Journal of Experimental & Clinical Cancer Research 2011, 30:36 http://www.jeccr.com/content/30/1/36 Page 5 of 7 Figure 1 Kaplan-Meier estimates of overall survival based on a landmark analysis at 6 months post-transplant, grouping patients according to prior history of cGVHD (p = .022). The 5- year survival rates of patients with and without prior history of cGVHD were 64% and 17%, respectively. Figure 2 Kaplan-Meier estimates of overall survival based on a landmark analysis at 6 months post-transplant, grouping patients according to cytogenetics and prior history of cGVHD (p = .039). The 5-year survival rates of patients with intermediate & prior history of cGVHD +, poor & prior history of cGVHD +, and poor & prior history of cGVHD - were 75%, 33%, and 20%, respectively. Figure 3 Kaplan-Meier estimates of overall survival based on a landmark analysis at 6 months post-transplant, grouping patients according to percent marrow blast (≤ or > 26%) at baseline and prior history of cGVHD (p = .147). Patients with CNS lesion were not included in this analysis. The 5-year survival rates of patients with fewer blast & prior history of cGVHD +, higher blast & prior history of cGVHD +, and fewer blast & prior history of cGVHD - were 83%, 33%, and 25%, respectively. term allo-HCT outcomes in adult patients with acute leukemia not in remission [9]. However, they did not address the effect of cGVHD on survival. Baron et al. have reported that extensive cGVHD was associated with decreased risk of progression or relapse in patients with AML or MDS in complete remission at the time of nonmyeloablative HCT [16]. However, it remains unclear whether cGVHD is associated with long-term disease control in patients who have active leukemia at transplant. The results of the current study showed that GVL effects mediated by cGVHD may play a crucial role in long-term survival in or a cure of active leuke- mia, especially in patients without poor-risk cytoge- netics. Further study on the possible relationship between cGVHD and GVL effects would be very helpful in the management of immunosuppressive treatment. For patients who were ineligible for myeloablative conditioning due to comorbidities coupled with rapidly progressive leukemia, we administered sequential cytore- ductive chemotherapy, followed by reduced-intensity conditioning for allo-HCT in order to reduce toxicity and obtain sufficient anti-leukemic efficacy. The utility of the combination of sequential cytoreductive che- motherapy and reduced-intensity conditioning for allo- HCT was previously reported [17]. Our results did not