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タイトル: | Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood Transplantation |
著者: | Wada, Fumiya Kanda, Junya https://orcid.org/0000-0002-6704-3633 (unconfirmed) Kamijo, Kimimori Nishikubo, Masashi Yoshioka, Satoshi Ishikawa, Takayuki Ueda, Yasunori Akasaka, Takashi Arai, Yasuyuki https://orcid.org/0000-0002-9662-5093 (unconfirmed) Izumi, Kiyotaka Hirata, Hirokazu Ikeda, Takashi Yonezawa, Akihito Anzai, Naoyuki Watanabe, Mitsumasa Imada, Kazunori Yago, Kazuhiro Tamura, Naoki Itoh, Mitsuru Masuo, Yuki Kunitomi, Akane Takeoka, Tomoharu Kitano, Toshiyuki Arima, Nobuyoshi Hishizawa, Masakatsu Asagoe, Kohsuke Kondo, Tadakazu Takaori-Kondo, Akifumi |
著者名の別形: | 和田, 典也 諫田, 淳也 新井, 康之 近藤, 忠一 髙折, 晃史 |
キーワード: | acute graft-versus-host disease chronic graft-versus-host disease haploidentical posttransplant cyclophosphamide cord blood transplantation hematological malignancies |
発行日: | 2023 |
出版者: | SAGE Publications |
誌名: | Cell Transplantation |
巻: | 32 |
論文番号: | 9636897231194497 |
抄録: | 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. |
著作権等: | © The Author(s) 2023. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
URI: | http://hdl.handle.net/2433/286731 |
DOI(出版社版): | 10.1177/09636897231194497 |
PubMed ID: | 37646153 |
出現コレクション: | 学術雑誌掲載論文等 |
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