Associations between acute and chronic graft-versus-host disease

被引:0
作者
Tamaki, Masaharu [1 ,2 ]
Akahoshi, Yu [1 ,3 ]
Inamoto, Yoshihiro [4 ]
Morita, Kaoru [5 ]
Uchida, Naoyuki [6 ]
Doki, Noriko [7 ]
Tanaka, Masatsugu [8 ]
Nishida, Tetsuya [9 ]
Ohigashi, Hiroyuki [10 ]
Nakamae, Hirohisa [11 ]
Onizuka, Makoto [12 ]
Katayama, Yuta [13 ,14 ]
Matsuoka, Ken-ichi [15 ]
Sawa, Masashi [16 ]
Ishimaru, Fumihiko [17 ]
Kanda, Yoshinobu [1 ,5 ]
Fukuda, Takahiro [18 ]
Atsuta, Yoshiko [19 ,20 ]
Terakura, Seitaro [21 ]
Kanda, Junya [22 ]
机构
[1] Jichi Med Univ, Saitama Med Ctr, Div Hematol, 1-847 Amanuma Cho,Omiya Ku, Saitama 3308503, Japan
[2] Jichi Med Univ, Ctr Mol Med, Div Emerging Med Integrated Therapeut, Shimotsuke, Japan
[3] Icahn Sch Med Mt Sinai, Tisch Canc Inst, Div Hematol Med Oncol, New York, NY USA
[4] Fujita Hlth Univ, Sch Med, Dept Bone & Marrow Transplantat & Cellular Therapy, Toyoake, Japan
[5] Jichi Med Univ, Div Hematol, Shimotsuke, Japan
[6] Federat Natl Publ Serv Personnel Mutual Aid Assoc, Toranomon Hosp, Dept Hematol, Tokyo, Japan
[7] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Hematol Div, Tokyo, Japan
[8] Kanagawa Canc Ctr, Dept Hematol, Yokohama, Japan
[9] Nagoya Daiichi Hosp, Japanese Red Cross Aichi Med Ctr, Dept Hematol, Nagoya, Japan
[10] Hokkaido Univ Hosp, Dept Hematol, Sapporo, Japan
[11] Osaka Metropolitan Univ Hosp, Dept Hematol, Osaka, Japan
[12] Tokai Univ, Sch Med, Dept Hematol Oncol, Isehara, Japan
[13] Hiroshima Red Cross Hosp, Dept Hematol, Hiroshima, Japan
[14] Atom bomb Survivors Hosp, Hiroshima, Japan
[15] Okayama Univ Hosp, Dept Hematol & Oncol, Okayama, Japan
[16] Anjo Kosei Hosp, Dept Hematol & Oncol, Anjo, Japan
[17] Japanese Red Cross Soc Blood Serv Headquarters, Tech Dept, Tokyo, Japan
[18] Natl Canc Ctr, Dept Hematopoiet Stem Cell Transplantat, Tokyo, Japan
[19] Japanese Data Ctr Hematopoiet Cell Transplantat, Nagakute, Japan
[20] Aichi Med Univ, Sch Med, Dept Registry Sci Transplant & Cellular Therapy, Nagakute, Japan
[21] Nagoya Univ, Grad Sch Med, Dept Hematol & Oncol, Nagoya, Japan
[22] Kyoto Univ, Grad Sch Med, Dept Hematol & Oncol, Kyoto, Japan
关键词
HEMATOPOIETIC-CELL TRANSPLANTATION; CONSENSUS DEVELOPMENT PROJECT; BONE-MARROW-TRANSPLANTATION; UMBILICAL-CORD BLOOD; RISK-FACTORS; CHRONIC GVHD; NONRELAPSE MORTALITY; INTERNATIONAL BLOOD; CLINICAL-TRIALS; ORGAN INVOLVEMENT;
D O I
10.1182/bloodadvances.2024013442
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Chronic graft-versus-host disease (GVHD) is 1 of the major complications after allogeneic hematopoietic cell transplantation (allo-HCT). Although various risk factors for chronic GVHD have been reported, limited data are available regarding the impact of acute GVHD on chronic GVHD. We examined the association between acute and chronic GVHD using a Japanese registry data set. The landmark point was set at day 100 after allo-HCT, and patients who died or relapsed before the landmark point were excluded. In total, 14 618 and 6135 patients who underwent allo-HCT with bone marrow or peripheral blood (BM/PB) and with umbilical cord blood (UCB), respectively, were analyzed. In the BM/PB cohort, the risk for chronic GVHD that requires systemic steroids increased with each increase in acute GVHD grade from 0 to 2 (grade 0 vs 1 [hazard ratio (HR), 1.32; 95% confidence interval (CI), 1.19-1.46; P < .001]; grade 1 vs 2 [HR, 1.41; 95% CI, 1.28-1.56; P < .001]), but the risk was similar between acute GVHD grade 2 and grade 3 to 4 (HR, 1.02; 95% CI, 0.91-1.15; P = 1.0). These findings were confirmed in the UCB cohort. We further observed that the risk for severe chronic GVHD increased with each increment in the grade of acute GVHD, even between acute GVHD grade 2 and grade 3 to (grade 2 vs 3-4: HR, 1.70; 95% CI, 1.12-2.58; P = .025). In conclusion, the preceding profiles of acute GVHD should help to stratify the risk for chronic GVHD and its severity, which might be useful for the development of riskadopted preemptive strategies for chronic GVHD.
引用
收藏
页码:4250 / 4261
页数:12
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