prophylaxis of graftversushost disease with cyclosporineprednisone is associated with increased risk of chronic graftversushost disease to determine the effect of two different graftversushost disease gvhd prophylactic regimenscyclosporine with short course of methotrexate cyamtx and cyclosporine with prednisone cyapredon the incidence of chronic gvhd cgvhd we retrospectively reviewed the outcomes of 196 consecutive allogeneic related blood and marrow transplants performed at our institution utilizing one of these regimens cyapred was given to patients who were transplanted more recently because of concern about the increased risk of venoocclusive disease of the liver increased mucositis and slower engraftment in patients receiving cyamtx prophylaxis with cyapred was associated with a higher risk of development of cgvhd risk ratio rr 35 95 confidence intrerval ci 2254 the proportion of patients with extensive disease among those developing cgvhd was higher in the cyapred group 71 than in the cyamtx group 57 although this difference was not statistically significant the cumulative probability of extensive cgvhd at 2 years was higher in the cyapred group rr 42 95 ci 2474 development of acute gvhd and cytomegalovirus mismatch were independent predictors of increased risk of cgvhd we conclude that gvhd prophylaxis with cyapred is associated with a higher overall rate of cgvhd compared to cyamtx the type of gvhd prophylaxis should be considered when comparing the incidence of cgvhd reported in different studies