Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood Transplantation
Haploidentical-related donor transplantation using posttransplant cyclophosphamide (PTCy-haplo) and cord blood transplantation (CBT) are valid alternatives for patients with hematological malignancies when HLA-matched donor transplantation (MDT) is unavailable. However, the effects of graft-versus-h...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-08-01
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| Series: | Cell Transplantation |
| Online Access: | https://doi.org/10.1177/09636897231194497 |
| _version_ | 1797731237941477376 |
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| author | Fumiya Wada Junya Kanda Kimimori Kamijo Masashi Nishikubo Satoshi Yoshioka Takayuki Ishikawa Yasunori Ueda Takashi Akasaka Yasuyuki Arai Kiyotaka Izumi Hirokazu Hirata Takashi Ikeda Akihito Yonezawa Naoyuki Anzai Mitsumasa Watanabe Kazunori Imada Kazuhiro Yago Naoki Tamura Mitsuru Itoh Yuki Masuo Akane Kunitomi Tomoharu Takeoka Toshiyuki Kitano Nobuyoshi Arima Masakatsu Hishizawa Kohsuke Asagoe Tadakazu Kondo Akifumi Takaori-Kondo |
| author_facet | Fumiya Wada Junya Kanda Kimimori Kamijo Masashi Nishikubo Satoshi Yoshioka Takayuki Ishikawa Yasunori Ueda Takashi Akasaka Yasuyuki Arai Kiyotaka Izumi Hirokazu Hirata Takashi Ikeda Akihito Yonezawa Naoyuki Anzai Mitsumasa Watanabe Kazunori Imada Kazuhiro Yago Naoki Tamura Mitsuru Itoh Yuki Masuo Akane Kunitomi Tomoharu Takeoka Toshiyuki Kitano Nobuyoshi Arima Masakatsu Hishizawa Kohsuke Asagoe Tadakazu Kondo Akifumi Takaori-Kondo |
| author_sort | Fumiya Wada |
| collection | DOAJ |
| description | Haploidentical-related donor transplantation using posttransplant cyclophosphamide (PTCy-haplo) and cord blood transplantation (CBT) are valid alternatives for patients with hematological malignancies when HLA-matched donor transplantation (MDT) is unavailable. However, the effects of graft-versus-host disease (GVHD) on outcomes after these transplants have not been fully elucidated. Therefore, we evaluated the effects of acute and chronic GVHD on transplant outcomes after PTCy-haplo transplants and compared them with CBT and MDT. We included a total of 914 adult patients with hematological malignancies in the Kyoto Stem Cell Transplantation Group registry who received PTCy-haplo (N = 120), CBT (N = 402), and MDT (N = 392), and achieved neutrophil engraftment. A multivariate analysis revealed that grade I–II acute GVHD improved of overall survival (OS) after PTCy-haplo [hazard ratio (HR) = 0.39, P = 0.018] and CBT (HR = 0.48, P < 0.001), but not after MDT (HR = 0.80, P = 0.267) compared with patients without acute GVHD. Grade I–II acute GVHD had a trend toward reducing the risk of nonrelapse mortality (NRM) after PTCy-haplo (HR = 0.13, P = 0.060) and this positive effect was significant after CBT (HR = 0.39, P = 0.003). A negative impact of grade III–IV acute GVHD on NRM was observed after CBT and MDT, but not after PTCy-haplo. Limited chronic GVHD had a positive impact on OS after CBT and MDT, but not after PTCy-haplo. In conclusion, mild acute GVHD improved outcomes after PTCy-haplo and CBT, and limited chronic GVHD improved outcomes after CBT and MDT. These data indicated that the effects of GVHD on transplant outcomes depended on transplant platforms. |
| first_indexed | 2024-03-12T11:56:51Z |
| format | Article |
| id | doaj.art-9e9f608734264cc4a084a24e70911b2b |
| institution | Directory Open Access Journal |
| issn | 1555-3892 |
| language | English |
| last_indexed | 2024-03-12T11:56:51Z |
| publishDate | 2023-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Cell Transplantation |
| spelling | doaj.art-9e9f608734264cc4a084a24e70911b2b2023-08-30T21:03:29ZengSAGE PublishingCell Transplantation1555-38922023-08-013210.1177/09636897231194497Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood TransplantationFumiya Wada0Junya Kanda1Kimimori Kamijo2Masashi Nishikubo3Satoshi Yoshioka4Takayuki Ishikawa5Yasunori Ueda6Takashi Akasaka7Yasuyuki Arai8Kiyotaka Izumi9Hirokazu Hirata10Takashi Ikeda11Akihito Yonezawa12Naoyuki Anzai13Mitsumasa Watanabe14Kazunori Imada15Kazuhiro Yago16Naoki Tamura17Mitsuru Itoh18Yuki Masuo19Akane Kunitomi20Tomoharu Takeoka21Toshiyuki Kitano22Nobuyoshi Arima23Masakatsu Hishizawa24Kohsuke Asagoe25Tadakazu Kondo26Akifumi Takaori-Kondo27Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, JapanDepartment of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, JapanDepartment of Hematology, Kobe City Medical Center General Hospital, Kobe, JapanDepartment of Hematology, Kobe City Medical Center General Hospital, Kobe, JapanDepartment of Hematology, Japanese Red Cross Osaka Hospital, Osaka, JapanDepartment of Hematology, Kobe City Medical Center General Hospital, Kobe, JapanDepartment of Hematology/Oncology, Kurashiki Central Hospital, Okayama, JapanDepartment of Hematology, Tenri Hospital, Tenri, JapanDepartment of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, JapanDepartment of Hematology, Kansai Electric Power Hospital, Osaka, JapanDepartment of Hematology, Kansai Electric Power Hospital, Osaka, JapanDivision of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, JapanDepartment of Hematology, Kokura Memorial Hospital, Fukuoka, JapanDepartment of Hematology, Takatsuki Red Cross Hospital, Osaka, JapanDepartment of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, JapanDepartment of Hematology, Japanese Red Cross Osaka Hospital, Osaka, JapanDepartment of Hematology, Shizuoka General Hospital, Shizuoka, JapanDepartment of Hematology, Kyoto City Hospital, Kyoto, JapanDepartment of Hematology, Kyoto City Hospital, Kyoto, JapanDepartment of Hematology and Immunology, Japanese Red Cross Otsu Hospital, Shiga, JapanDepartment of Hematology and Immunology, Japanese Red Cross Otsu Hospital, Shiga, JapanDepartment of Hematology and Immunology, Japanese Red Cross Otsu Hospital, Shiga, JapanDepartment of Hematology, Kitano Hospital, Osaka, JapanDepartment of Hematology, Shinko Hospital, Hyogo, JapanDepartment of Hematology, Kyoto-Katsura Hospital, Kyoto, JapanDepartment of Hematology, Shiga General Hospital, Shiga, JapanDepartment of Hematology, Kobe City Medical Center General Hospital, Kobe, JapanDepartment of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, JapanHaploidentical-related donor transplantation using posttransplant cyclophosphamide (PTCy-haplo) and cord blood transplantation (CBT) are valid alternatives for patients with hematological malignancies when HLA-matched donor transplantation (MDT) is unavailable. However, the effects of graft-versus-host disease (GVHD) on outcomes after these transplants have not been fully elucidated. Therefore, we evaluated the effects of acute and chronic GVHD on transplant outcomes after PTCy-haplo transplants and compared them with CBT and MDT. We included a total of 914 adult patients with hematological malignancies in the Kyoto Stem Cell Transplantation Group registry who received PTCy-haplo (N = 120), CBT (N = 402), and MDT (N = 392), and achieved neutrophil engraftment. A multivariate analysis revealed that grade I–II acute GVHD improved of overall survival (OS) after PTCy-haplo [hazard ratio (HR) = 0.39, P = 0.018] and CBT (HR = 0.48, P < 0.001), but not after MDT (HR = 0.80, P = 0.267) compared with patients without acute GVHD. Grade I–II acute GVHD had a trend toward reducing the risk of nonrelapse mortality (NRM) after PTCy-haplo (HR = 0.13, P = 0.060) and this positive effect was significant after CBT (HR = 0.39, P = 0.003). A negative impact of grade III–IV acute GVHD on NRM was observed after CBT and MDT, but not after PTCy-haplo. Limited chronic GVHD had a positive impact on OS after CBT and MDT, but not after PTCy-haplo. In conclusion, mild acute GVHD improved outcomes after PTCy-haplo and CBT, and limited chronic GVHD improved outcomes after CBT and MDT. These data indicated that the effects of GVHD on transplant outcomes depended on transplant platforms.https://doi.org/10.1177/09636897231194497 |
| spellingShingle | Fumiya Wada Junya Kanda Kimimori Kamijo Masashi Nishikubo Satoshi Yoshioka Takayuki Ishikawa Yasunori Ueda Takashi Akasaka Yasuyuki Arai Kiyotaka Izumi Hirokazu Hirata Takashi Ikeda Akihito Yonezawa Naoyuki Anzai Mitsumasa Watanabe Kazunori Imada Kazuhiro Yago Naoki Tamura Mitsuru Itoh Yuki Masuo Akane Kunitomi Tomoharu Takeoka Toshiyuki Kitano Nobuyoshi Arima Masakatsu Hishizawa Kohsuke Asagoe Tadakazu Kondo Akifumi Takaori-Kondo Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood Transplantation Cell Transplantation |
| title | Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood Transplantation |
| title_full | Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood Transplantation |
| title_fullStr | Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood Transplantation |
| title_full_unstemmed | Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood Transplantation |
| title_short | Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood Transplantation |
| title_sort | mild acute graft versus host disease improves outcomes after hla haploidentical related donor transplantation using posttransplant cyclophosphamide and cord blood transplantation |
| url | https://doi.org/10.1177/09636897231194497 |
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