Bibliographic Details
| Title: |
Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood Transplantation. |
| Authors: |
Wada, Fumiya, Kanda, Junya, Kamijo, Kimimori, Nishikubo, Masashi, Yoshioka, Satoshi, Ishikawa, Takayuki, Ueda, Yasunori, Akasaka, Takashi, Arai, Yasuyuki, Izumi, Kiyotaka, Hirata, Hirokazu, Ikeda, Takashi, Yonezawa, Akihito, Anzai, Naoyuki, Watanabe, Mitsumasa, Imada, Kazunori, Yago, Kazuhiro, Tamura, Naoki, Itoh, Mitsuru, Masuo, Yuki |
| Source: |
Cell Transplantation; Jan-Dec2023, Vol. 32, p1-14, 14p |
| Subject Terms: |
CORD blood transplantation, GRAFT versus host disease, STEM cell transplantation, TREATMENT effectiveness, CYCLOPHOSPHAMIDE, ACUTE diseases |
| Abstract: |
Haploidentical-related donor transplantation using posttransplant cyclophosphamide (PTCy-haplo) and cord blood transplantation (CBT) are valid alternatives for patients with hematological malignancies when HLA-matched donor transplantation (MDT) is unavailable. However, the effects of graft-versus-host disease (GVHD) on outcomes after these transplants have not been fully elucidated. Therefore, we evaluated the effects of acute and chronic GVHD on transplant outcomes after PTCy-haplo transplants and compared them with CBT and MDT. We included a total of 914 adult patients with hematological malignancies in the Kyoto Stem Cell Transplantation Group registry who received PTCy-haplo (N = 120), CBT (N = 402), and MDT (N = 392), and achieved neutrophil engraftment. A multivariate analysis revealed that grade I-II acute GVHD improved of overall survival (OS) after PTCy-haplo [hazard ratio (HR) = 0.39, P = 0.018] and CBT (HR = 0.48, P < 0.001), but not after MDT (HR = 0.80, P = 0.267) compared with patients without acute GVHD. Grade I-II acute GVHD had a trend toward reducing the risk of nonrelapse mortality (NRM) after PTCy-haplo (HR = 0.13, P = 0.060) and this positive effect was significant after CBT (HR = 0.39, P = 0.003). A negative impact of grade III-IV acute GVHD on NRM was observed after CBT and MDT, but not after PTCy-haplo. Limited chronic GVHD had a positive impact on OS after CBT and MDT, but not after PTCy-haplo. In conclusion, mild acute GVHD improved outcomes after PTCy-haplo and CBT, and limited chronic GVHD improved outcomes after CBT and MDT. These data indicated that the effects of GVHD on transplant outcomes depended on transplant platforms. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
