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.
Narimatsu
Hiroto
H
Divison of Exploratory Research, Institute of Medical Science, The University of Tokyo, Japan. narimt54@med.nagoya-u.ac.jp
Miyakoshi
Shigesaburo
S
Yamaguchi
Takuhiro
T
Kami
Masahiro
M
Matsumura
Tomoko
T
Yuji
Koichiro
K
Murashige
Naoko
N
Kusumi
Eiji
E
Kodama
Yuko
Y
Komatsu
Tsunehiko
T
Sakamaki
Hisashi
H
Kouzai
Yasushi
Y
Okada
Masaya
M
Osugi
Yuko
Y
Kobayashi
Ryoji
R
Inoue
Masami
M
Takahashi
Satoshi
S
Kai
Shunro
S
Kato
Koji
K
Inoue-Nagamura
Tokiko
T
Taniguchi
Shuichi
S
Kato
Shunichi
S
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