Impact of recipient statin treatment on graft-versus-host disease after allogeneic hematopoietic cell transplantation.
We retrospectively analyzed outcomes among 1206 patients with hematologic malignancies who had hematopoietic cell transplantation (HCT) from HLA-identical siblings (n = 630) or HLA-matched unrelated donors (n = 576) at a single institution between 2001 and 2007 for a correlation between recipient statin use and risk of graft-versus-host disease (GVHD). Among recipients with cyclosporine-based postgrafting immunosuppression (n = 821), statin use at the time of transplant (6%) was associated with a decreased risk of extensive chronic GVHD (cGVHD) (multivariate hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.4-1.0; P = .05) and an increased risk of recurrent malignancy (HR, 1.75; 95% CI, 1.0-3.0; P = .04). Recipient statin use, however, had no apparent impact on the risks of cGVHD and recurrent malignancy among recipients given tacrolimus-based immunosuppression (n = 385; 8% statin treated). Risks of acute GVHD, nonrelapse mortality, and overall mortality were not significantly affected by recipient statin use. Hence, recipient statin treatment at the time of allogeneic HCT may decrease the risk of cGVHD in patients with cyclosporine-based immunosuppression, but at the expense of a compromised graft-versus-tumor effect.
Rotta
Marcello
M
Division of Clinical Research, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington 98109, USA.
Storer
Barry E
BE
Storb
Rainer
R
Martin
Paul J
PJ
Flowers
Mary E D
ME
Vernon
Miwa S
MS
Peffer
Amanda
A
Maloney
David G
DG
Deeg
H Joachim
HJ
Sandmaier
Brenda M
BM
Appelbaum
Frederick R
FR
Mielcarek
Marco
M
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D016572:Cyclosporine / Q000627:therapeutic use; D004347:Drug Interactions; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D020350:Graft vs Tumor Effect / Q000187:drug effects*; D019337:Hematologic Neoplasms / Q000401:mortality / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D013601:T-Lymphocytes / Q000187:drug effects*; D014184:Transplantation, Homologous / Q000009:adverse effects; D055815:Young Adult
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine