Outcomes of chronic graft-versus-host disease following matched sibling donor versus umbilical cord blood transplant

Grigori Okoev, Daniel J. Weisdorf, John E. Wagner, Bruce R. Blazar, Margaret L. MacMillan, Todd DeFor, Aleksandr Lazaryan, Najla El Jurdi, Shernan G. Holtan, Claudio G. Brunstein, Brian C. Betts, Takuto Takahashi, Veronika Bachanova, Erica D. Warlick, Armin Rashidi, Mukta Arora

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

We compared chronic graft-versus-host disease (cGvHD) following umbilical cord blood (UCBT) and matched sibling donor peripheral blood transplant (MSD). 145 patients (2010–2017) with cGvHD after MSD (n = 104) and UCBT (n = 41) were included. Prior acute GvHD was less frequent in MSD (55% vs. 85%; p = 0.01). Severe cGvHD (32% vs. 15%, p = 0.01) and de-novo onset (45% vs. 15%, p < 0.01) were more frequent following MSD. Liver was more frequently involved in MSD recipients (38% vs. 6%); and GI in UCBT (33% vs. 63%), both p < 0.01. Overall response (CR + PR) was similar between both cohorts. 2-year CR was higher in UCBT (14% vs 33%, p = 0.02). Karnofsky score (KPS) ≥ 90 at cGvHD diagnosis was associated with higher odds of response (95%CI: 1.42–10, p < 0.01). The cumulative incidence of durable discontinuation of immune-suppressive therapy, failure-free survival (FFS) and NRM at 2-years were similar between cohorts. KPS < 90 (95%CI: 3.1–24.9, p < 0.01) and platelets <100 × 10e9/L (95%CI: 1.25–10, p = 0.01) were associated with higher risk of NRM. UCBT patients were more likely to have a prior acute GvHD, less severe cGvHD and more likely to attain CR. Despite differences, both cohorts had similar NRM and FFS. High-risk groups, including those with platelets <100 × 10e9/L and KPS < 90, need careful monitoring and intensified therapy.

Original languageEnglish (US)
Pages (from-to)1373-1380
Number of pages8
JournalBone marrow transplantation
Volume56
Issue number6
Early online dateJan 8 2021
DOIs
StatePublished - Jun 2021

Bibliographical note

Funding Information:
Conflict of interest DJW - research support from Incyte. JEW - advisor at Magenta Therapeutics. BRB - founder of Tmunity Therapeutics, advisory board member for Kadmon Pharmaceuticals, Magenta Therapeutics, and BlueRock Therapeutics and receives research funding from BlueRock Therapeutics. SGH – consultant for Incyte, Bristol Meyers Squibb, and Generon.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Limited.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

PubMed: MeSH publication types

  • Journal Article

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