Outcomes of chronic graft-versus-host disease following matched sibling donor versus umbilical cord blood transplant.
Bone Marrow Transplant
; 56(6): 1373-1380, 2021 06.
Article
de En
| MEDLINE
| ID: mdl-33420387
ABSTRACT
We compared chronic graft-versus-host disease (cGvHD) following umbilical cord blood (UCBT) and matched sibling donor peripheral blood transplant (MSD). 145 patients (2010-2017) with cGvHD after MSD (n = 104) and UCBT (n = 41) were included. Prior acute GvHD was less frequent in MSD (55% vs. 85%; p = 0.01). Severe cGvHD (32% vs. 15%, p = 0.01) and de-novo onset (45% vs. 15%, p < 0.01) were more frequent following MSD. Liver was more frequently involved in MSD recipients (38% vs. 6%); and GI in UCBT (33% vs. 63%), both p < 0.01. Overall response (CR + PR) was similar between both cohorts. 2-year CR was higher in UCBT (14% vs 33%, p = 0.02). Karnofsky score (KPS) ≥ 90 at cGvHD diagnosis was associated with higher odds of response (95%CI 1.42-10, p < 0.01). The cumulative incidence of durable discontinuation of immune-suppressive therapy, failure-free survival (FFS) and NRM at 2-years were similar between cohorts. KPS < 90 (95%CI 3.1-24.9, p < 0.01) and platelets <100 × 10e9/L (95%CI 1.25-10, p = 0.01) were associated with higher risk of NRM. UCBT patients were more likely to have a prior acute GvHD, less severe cGvHD and more likely to attain CR. Despite differences, both cohorts had similar NRM and FFS. High-risk groups, including those with platelets <100 × 10e9/L and KPS < 90, need careful monitoring and intensified therapy.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Transplantation de cellules souches hématopoïétiques
/
Transplantation de cellules souches de sang du cordon
/
Maladie du greffon contre l'hôte
Type d'étude:
Etiology_studies
Limites:
Humans
Langue:
En
Journal:
Bone Marrow Transplant
Sujet du journal:
TRANSPLANTE
Année:
2021
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique