NYMC Faculty Publications
DOI
10.1038/bmt.2016.265
Journal Title
Bone Marrow Transplantation
First Page
400
Last Page
408
Document Type
Article
Publication Date
3-1-2017
Department
Pediatrics
Keywords
Acute Disease, Adolescent, Antilymphocyte Serum administration & dosage, Child, Preschool child, Chronic DiseaseCord Blood Stem Cell Transplantation, Disease-Free Survival, Female, Graft vs Host Disease etiology, Graft vs Host Disease mortality, Graft vs Host Disease prevention & control, Humans, Newborn Infant, Leukemia mortality, Leukemia therapy, Male, Registries, Survival Rate, Transplantation Conditioning, antilymphocyte serum, multicenter study, clinical trial
Disciplines
Medicine and Health Sciences
Abstract
Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, we analyzed 1404 umbilical cord bloodtransplantation (UCBT) patients (single (<18 years)=810, double (⩾18 years)=594) with acute leukemia to define the incidence of acuteGvHD (aGvHD) and chronic GvHD (cGvHD), analyze clinical risk factors and investigate outcomes. After single UCBT, 100-day incidence of grade II-IV aGvHD was 39% (95% confidence interval (CI), 36-43%), grade III-IV aGvHD was 18% (95% CI, 15-20%) and 1-year cGvHD was 27% (95% CI, 24-30%). After double UCBT, 100-day incidence of grade II-IV aGvHD was 45% (95% CI, 41-49%), grade III-IV aGvHD was 22% (95% CI, 19-26%) and 1-year cGvHD was 26% (95% CI, 22-29%). For single UCBT, multivariate analysis showed that absence of antithymocyte globulin (ATG) was associated with aGvHD, whereas prior aGvHD was associated with cGvHD. For double UCBT, absence of ATG and myeloablative conditioning were associated with aGvHD, whereas prior aGvHD predicted for cGvHD. Grade III-IV aGvHD led to worse survival, whereas cGvHD had no significant effect on disease-free or overall survival. GvHD is prevalent after UCBT with severe aGvHD leading to higher mortality. Future research in UCBT should prioritize prevention of GvHD.
Recommended Citation
Chen, Y., Wang, T., Hemmer, M., Alousi, A., Pidala, J., Cairo, M., & Cutler, C. (2017). GvHD After Umbilical Cord Blood Transplantation for Acute Leukemia: an Analysis of Risk Factors and Effect on Outcomes. Bone Marrow Transplantation, 52 (3), 400-408. https://doi.org/10.1038/bmt.2016.265
Publisher's Statement
This is a post-peer-review, pre-copyedit version of an article published in Bone Marrow Transplantation. The final authenticated version is available online at: https://doi.org/10.1038/bmt.2016.265
Comments
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