title: Potential protective effect of Helicobacter pylori on the development of gastrointestinal GvHD.
abstract: Previous reports ascribe a modulating capacity of the immune response to Helicobacter pylori (HP). Our hypothesis was to demonstrate in a prospective study that HP infection could have a protective effect against development of gastrointestinal GvHD in patients receiving allogeneic hematopoietic cell transplantation (HCT). Presence of HP before transplant was determined using C(13) urea breath test. Seventy-nine patients receiving an allogeneic HCT were included and 93.7% of them received PBSC; in 51.9%, the donor was unrelated. Acute gastrointestinal GvHD was diagnosed in 51.9% (n=41). In the multivariable analysis, HP infection was associated with a lower frequency of gastrointestinal GvHD (odds ratio (OR)=0.19 (95% confidence interval (CI): 0.05-0.67); in contrast, an unrelated donor was associated with a higher frequency of gastrointestinal GvHD (odds ratio=5.4 (95% confidence interval: 1.6-18.2). One year overall survival (OS) was 74%. In the multivariate Cox proportional-hazards regression analysis, stages 0-II gastrointestinal GvHD (hazards ratio (HR)=0.19), reduced intensity conditioning (HR=0.04) and tacrolimus-sirolimus GvHD prophylaxis (HR=0.06) were all associated with a better OS. In summary, HP infection could have a role in decreasing gastrointestinal GvHD in patients receiving allogeneic HCT from peripheral blood including related and unrelated donors.
authors.affiliation: Department of Gastroenterology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Velasco-Guardado
authors.affiliation: Department of Gastroenterology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Mora-Soler
authors.affiliation: Department of Hematology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
authors.forename: L
authors.initials: L
authors.lastname: López-Corral
authors.affiliation: Department of Hematology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
authors.forename: O
authors.initials: O
authors.lastname: López-Godino
authors.affiliation: Department of Hematology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Vázquez-López
authors.affiliation: Department of Pathology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Blanco-Muñez
authors.affiliation: Department of Hematology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Pérez-López
authors.affiliation: Department of Gastroenterology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez-Pérez
authors.affiliation: Department of Hematology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Caballero-Barrigón
mesh_terms: D000328:Adult; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000382:microbiology; D006086:Graft vs Host Disease / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020123:Sirolimus / Q000627:therapeutic use; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use; D019172:Transplantation Conditioning / Q000379:methods
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus