GVHD after umbilical cord blood transplantation for acute leukemia: an analysis of risk factors and effect on outcomes View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-12-12

AUTHORS

Yi-Bin Chen, Tao Wang, Michael T. Hemmer, Colleen Brady, Daniel R. Couriel, Amin Alousi, Joseph Pidala, Alvaro Urbano-Ispizua, Sung Won Choi, Taiga Nishihori, Takanori Teshima, Yoshishiro Inamoto, Baldeep Wirk, David I Marks, Hisham Abdel-Azim, Leslie Lehmann, Lolie Yu, Menachem Bitan, Mitchell S. Cairo, Muna Qayed, Rachel Salit, Robert Peter Gale, Rodrigo Martino, Samantha Jaglowski, Ashish Bajel, Bipin Savani, Haydar Frangoul, Ian D. Lewis, Jan Storek, Medhat Askar, Mohamed A. Kharfan-Dabaja, Mahmoud Aljurf, Olle Ringden, Ran Reshef, Richard F. Olsson, Shahrukh Hashmi, Sachiko Seo, Thomas R. Spitzer, Margaret L. MacMillan, Aleksandr Lazaryan, Stephen R. Spellman, Mukta Arora, Corey S. Cutler

ABSTRACT

Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, we analyzed 1404 umbilical cord blood transplantation (UCBT) patients (single (<18 years)=810, double (⩾18 years)=594) with acute leukemia to define the incidence of acute GvHD (aGvHD) and chronic GvHD (cGvHD), analyze clinical risk factors and investigate outcomes. After single UCBT, 100-day incidence of grade II-IV aGvHD was 39% (95% confidence interval (CI), 36-43%), grade III-IV aGvHD was 18% (95% CI, 15-20%) and 1-year cGvHD was 27% (95% CI, 24-30%). After double UCBT, 100-day incidence of grade II-IV aGvHD was 45% (95% CI, 41-49%), grade III-IV aGvHD was 22% (95% CI, 19-26%) and 1-year cGvHD was 26% (95% CI, 22-29%). For single UCBT, multivariate analysis showed that absence of antithymocyte globulin (ATG) was associated with aGvHD, whereas prior aGvHD was associated with cGvHD. For double UCBT, absence of ATG and myeloablative conditioning were associated with aGvHD, whereas prior aGvHD predicted for cGvHD. Grade III-IV aGvHD led to worse survival, whereas cGvHD had no significant effect on disease-free or overall survival. GvHD is prevalent after UCBT with severe aGvHD leading to higher mortality. Future research in UCBT should prioritize prevention of GvHD. More... »

PAGES

400-408

Journal

TITLE

Bone Marrow Transplantation

ISSUE

3

VOLUME

52

Author Affiliations

  • Massachusetts General Hospital, Boston, Massachusetts
  • Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
  • Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
  • Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minneapolis
  • Utah Blood and Marrow Transplant Program, Adults, Salt Lake City, Utah
  • Division of Cancer Medicine, Department of Stem Cell Transplantation, University of Texas M.D. Anderson Cancer Center, Houston, Texas
  • H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
  • Department of Hematology, Hospital Clinic, University of Barcelona, IDIBAPS and Institute of Research Josep Carreras, Barcelona, Spain
  • The University of Michigan, Ann Arbor, MI
  • Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
  • Kyushu University Hospital, Fukuoka, Japan
  • Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
  • Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA
  • Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
  • Division of Hematology, Oncology and Blood & Marrow Transplantation, Children’s Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA
  • Dana-Farber Cancer Institute/Boston Children’s Hospital, Boston, MA
  • Dvision of Hematology/Oncology &HSCT, The Center for Cancer and Blood Disorders, Children’s Hospital/Louisiana State University Medical Center, New Orleans, LA
  • Department of Pediatric Hematology/Oncology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
  • Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla NY
  • Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
  • Fred Hutchinson Cancer Research Center, Seattle, WA
  • Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
  • Division of Clinical Hematology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
  • Division of Hematology, The Ohio State University Medical Center, Columbus, OH
  • Royal Malbourne Hospital City Campus, Victoria, Australia
  • Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
  • Division of Hematology-Oncology, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
  • Haematology and Bone Marrow Transplant Unit, Royal Adelaide Hospital. Adelaide, SA, Australia
  • Department of Medicine, University of Calgary, Calgary, AB, Canada
  • Baylor University Medical Center, Dallas, TX
  • Department of Blood and Marrow Transplantation, H. Lee Mofitt Cancer Center and Research Institute, Tampa, FL
  • Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
  • Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
  • Blood and Marrow Transplantation Program and Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY
  • Mayo Clinic Rochester, Rochester, MN
  • National Cancer Research Center, East Hospital, Kashiwa, Chiba, Japan
  • University of Minnesota Medical Center, Fairview, Minneapolis, MN
  • Division of Hematology, Oncology, Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota
  • Center for Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/bmt.2016.265

    DOI

    http://dx.doi.org/10.1038/bmt.2016.265

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1001864343

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27941764


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