Effect of graft-versus-host disease on outcomes after pediatric single cord blood transplantation

被引：9

作者：

Kanda, Junya ^{[1
]}

Umeda, Katsutsugu ^{[2
]}

Kato, Koji ^{[3
,4
]}

Murata, Makoto ^{[5
]}

Sugita, Junichi ^{[6
]}

Adachi, Souichi ^{[7
]}

Koh, Katsuyoshi ^{[8
]}

Noguchi, Maiko ^{[9
]}

Goto, Hiroaki ^{[10
]}

Yoshida, Nao ^{[3
]}

Sato, Maho ^{[11
,12
]}

Koga, Yuhki ^{[13
]}

Hori, Tsukasa ^{[14
]}

Cho, Yuko ^{[15
]}

Ogawa, Atsushi ^{[16
]}

Inoue, Masami ^{[11
,12
]}

Hashii, Yoshiko ^{[17
]}

Atsuta, Yoshiko ^{[18
,19
]}

Teshima, Takanori ^{[6
]}

机构：

[1] Kyoto Univ, Grad Sch Med, Dept Hematol & Oncol, Kyoto, Japan

[2] Kyoto Univ, Grad Sch Med, Dept Pediat, Kyoto, Japan

[3] Japanese Red Cross Nagoya First Hosp, Childrens Med Ctr, Dept Hematol & Oncol, Nagoya, Aichi, Japan

[4] Cent Japan Cord Blood Bank, Seto, Japan

[5] Nagoya Univ, Grad Sch Med, Dept Hematol & Oncol, Nagoya, Aichi, Japan

[6] Hokkaido Univ, Dept Hematol, Fac Med, Sapporo, Hokkaido, Japan

[7] Kyoto Univ, Grad Sch Med, Dept Human Hlth Sci, Kyoto, Japan

[8] Saitama Childrens Med Ctr, Dept Hematol Oncol, Saitama, Japan

[9] Natl Hosp Org Kyushu Canc Ctr, Dept Pediat, Fukuoka, Japan

[10] Kanagawa Childrens Med Ctr, Div Hematooncol Regenerat Med, Yokohama, Kanagawa, Japan

[11] Osaka Med Ctr, Dept Hematol Oncol, Osaka, Japan

[12] Res Inst Maternal & Child Hlth, Osaka, Japan

[13] Kyushu Univ Hosp, Dept Pediat, Fukuoka, Japan

[14] Sapporo Med Univ, Dept Pediat, Sch Med, Sapporo, Hokkaido, Japan

[15] Hokkaido Univ Hosp, Dept Pediat, Sapporo, Hokkaido, Japan

[16] Niigata Canc Ctr Hosp, Dept Pediat, Niigata, Japan

[17] Osaka Univ, Dept Pediat, Grad Sch Med, Suita, Osaka, Japan

[18] Japanese Data Ctr Hematopoiet Cell Transplantat, Nagoya, Aichi, Japan

[19] Nagoya Univ, Dept Healthcare Adm, Grad Sch Med, Nagoya, Aichi, Japan

来源：

BONE MARROW TRANSPLANTATION | 2020年 / 55卷 / 07期

关键词：

STEM-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; ACUTE-LEUKEMIA; UNRELATED DONORS; THYMIC RECOVERY; JAPAN SOCIETY; HLA MISMATCH; RISK-FACTORS; TRUMP DATA; ADULTS;

D O I：

10.1038/s41409-020-0853-1

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

The effect of GVHD on transplant outcomes after unrelated cord blood transplantation (UCBT) is not yet fully understood. Pediatric patients aged 0-15 years with acute leukemia or myelodysplastic syndrome who underwent their first UCBT (n = 740) were selected from the Japanese registry. Fifty percent of the patients received a UCB unit containing more than 5.0 x 10(7)/kg total nucleated cells. The occurrence of grade III-IV acute GVHD was associated with a higher risk of non-relapse mortality (NRM, hazard ratio [HR] 4.07, P < 0.001) compared with no acute GVHD. Grade I-II acute GVHD was not associated with NRM. The occurrence of grade I-II or grade III-IV acute GVHD was not associated with a relapse risk. These findings showed that grade I-II acute GVHD carried no survival benefit and grade III-IV acute GVHD had an adverse effect (HR 1.68, P = 0.007). The occurrence of limited chronic GVHD was associated with a low risk of overall mortality (HR 0.60, P = 0.045). Severe acute GVHD should be prevented because of its association with high overall mortality and NRM in pediatric single UCBT. Mild acute GVHD provides no overall benefit. Mild chronic GVHD may be beneficial for survival.

引用

页码：1430 / 1437

页数：8

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