TY - JOUR
T1 - Chronic Graft-Versus-Host Disease (cGVHD) following Unrelated Donor Hematopoietic Stem Cell Transplantation (HSCT)
T2 - Higher Response Rate In Recipients of Unrelated Donor (URD) Umbilical Cord Blood (UCB)
AU - Arora, Mukta
AU - Nagaraj, Sriharsha
AU - Wagner, John E.
AU - Barker, Juliet N.
AU - Brunstein, Claudio G.
AU - Burns, Linda J.
AU - DeFor, Todd E.
AU - McMillan, Margaret L.
AU - Miller, Jeffrey S.
AU - Weisdorf, Daniel J.
N1 - Funding Information:
This work was supported by grants from National Institutes of Health (NIH 1 P01-CA65493-01A8), Cord Blood Transplantation Study (COBLT Study: NO1-HB67139), T-Cell Depletion Trial (TCD trial: NO1-HB-47095), and Children’s Cancer Research Fund.
PY - 2007/10
Y1 - 2007/10
N2 - We present a comparative analysis of clinical presentation and response to treatment in 170 patients with chronic graft versus host disease (cGVHD) (123 following transplant from an unrelated donor [URD] and 47 from umbilical cord blood [UCB]). URD transplant recipients were significantly younger (median age 25 versus 39 years, P = .002; and the donor grafts were mostly HLA matched (67% versus 10%, P < .0001). UCB recipients had more frequent responses (complete remission [CR] + partial remission [PR]) to treatment (URD 48% versus UCB 74% at 2 months [P = .005]; 49% versus 78% at 6 months [P = .001] and 51% versus 72% at 1 year [P = .03] in the URD and UCB groups, respectively). Nonrelapse mortality (NRM) after diagnosis of cGVHD was worse after URD grafts. (1 year NRM 27% [19%-35%] URD versus 11% [2%-20%] UCB, P = .055). Separate multivariate analyses were performed in each cohort. In both, thrombocytopenia and no CR or PR at 2 months were independently associated with increased mortality. In addition, progressive onset of cGVHD was a significant predictor of increased mortality in URD cohort. These data suggest that cGVHD following UCB transplant may be more responsive to therapy and also lead to a lower NRM.
AB - We present a comparative analysis of clinical presentation and response to treatment in 170 patients with chronic graft versus host disease (cGVHD) (123 following transplant from an unrelated donor [URD] and 47 from umbilical cord blood [UCB]). URD transplant recipients were significantly younger (median age 25 versus 39 years, P = .002; and the donor grafts were mostly HLA matched (67% versus 10%, P < .0001). UCB recipients had more frequent responses (complete remission [CR] + partial remission [PR]) to treatment (URD 48% versus UCB 74% at 2 months [P = .005]; 49% versus 78% at 6 months [P = .001] and 51% versus 72% at 1 year [P = .03] in the URD and UCB groups, respectively). Nonrelapse mortality (NRM) after diagnosis of cGVHD was worse after URD grafts. (1 year NRM 27% [19%-35%] URD versus 11% [2%-20%] UCB, P = .055). Separate multivariate analyses were performed in each cohort. In both, thrombocytopenia and no CR or PR at 2 months were independently associated with increased mortality. In addition, progressive onset of cGVHD was a significant predictor of increased mortality in URD cohort. These data suggest that cGVHD following UCB transplant may be more responsive to therapy and also lead to a lower NRM.
KW - Hematopoietic stem cell transplantation
KW - Umbilical cord blood transplant
KW - cGVHD
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U2 - 10.1016/j.bbmt.2007.06.004
DO - 10.1016/j.bbmt.2007.06.004
M3 - Article
C2 - 17889350
AN - SCOPUS:34548695657
SN - 1083-8791
VL - 13
SP - 1145
EP - 1152
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 10
ER -