. The value of the Pesaro
classification is that it provides a powerful demonstration of how the
quality of medical care that patients have received during their
entire life before transplant is a critical determinant of transplant
outcome. Prevention of transfusion and iron overload-related tissue
damage primarily yields a greater probability to overcome the toxic
and immunologic insults that are required to obtain and sustain
engraftment. Gaziev et al13 demonstrated, in a large retrospective
study, that GVHD incidence and severity were similar in the three
categories of patients, but what was much different was the
probability of surviving GVHD: mortality rate following acute