Chronic graft-versus-host disease following umbilical cord blood transplantation: retrospective survey involving 1072 patients in Japan.
We have little information on chronic graft-versus-host disease (GVHD) after cord blood transplantation (CBT). We investigated its clinical features in 1072 Japanese patients with hematologic malignancies who received a transplant through the Japan Cord Blood Bank Network. The primary end point was to investigate the incidence of any chronic GVHD. Median age of the patients was 33 years (range, 0-79 years). The cumulative incidence of chronic GVHD 2 years after transplantation was 28%. Chronic GVHD was fatal in 29 patients. Multivariate analysis demonstrated that development of chronic GVHD was favorably associated with both overall survival and event-free survival. Multivariate analysis identified risk factors of chronic GVHD: higher patient body weight, higher number of mismatched antigens for GVHD direction, myeloablative preparative regimen, use of mycophenolate mofetil in GVHD prophylaxis, and development of grades II to IV acute GVHD. Although chronic GVHD is a significant problem after CBT, it is associated with improved survival, perhaps due to graft-versus-malignancy effects.
Divison of Exploratory Research, Institute of Medical Science, The University of Tokyo, Japan. narimt54@med.nagoya-u.ac.jp
Hiroto
H
Narimatsu
Shigesaburo
S
Miyakoshi
Takuhiro
T
Yamaguchi
Masahiro
M
Kami
Tomoko
T
Matsumura
Koichiro
K
Yuji
Naoko
N
Murashige
Eiji
E
Kusumi
Yuko
Y
Kodama
Tsunehiko
T
Komatsu
Hisashi
H
Sakamaki
Yasushi
Y
Kouzai
Masaya
M
Okada
Yuko
Y
Osugi
Ryoji
R
Kobayashi
Masami
M
Inoue
Satoshi
S
Takahashi
Shunro
S
Kai
Koji
K
Kato
Tokiko
T
Inoue-Nagamura
Shuichi
S
Taniguchi
Shunichi
S
Kato
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D003625:Data Collection; D006086:Graft vs Host Disease / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis