Impact of graft-versus-host disease on outcomes after unrelated cord blood transplantation

J. Kanda; Y. Morishima; S. Terakura; A. Wake; N. Uchida; S. Takahashi; Y. Ono; Y. Onishi; H. Kanamori; N. Aotsuka; Y. Ozawa; H. Ogawa; T. Sakura; K. Ohashi; T. Ichinohe; K. Kato; Y. Atsuta; T. Teshima; M. Murata

doi:10.1038/leu.2016.288

Impact of graft-versus-host disease on outcomes after unrelated cord blood transplantation

J. Kanda, Y. Morishima, S. Terakura, A. Wake, N. Uchida, S. Takahashi, Y. Ono, Y. Onishi, H. Kanamori, N. Aotsuka, Y. Ozawa, H. Ogawa, T. Sakura, K. Ohashi, T. Ichinohe, K. Kato, Y. Atsuta, T. Teshima, M. Murata

Research output: Contribution to journal › Article › peer-review

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Abstract

The effect of graft-versus-host disease (GVHD) on transplant outcomes after unrelated cord blood transplantation (UCBT) has not been fully elucidated. We analyzed the impact of acute and chronic GVHD on outcomes in adult patients with acute leukemia or myelodysplastic syndrome who underwent their first UCBT (n=2558). The effect of GVHD on outcomes was analyzed after adjusting for other significant variables. The occurrence of GVHD was treated as a time-dependent covariate. The occurrence of grade 1-2 or 3-4 acute GVHD was significantly associated with a lower relapse rate. Grade 3-4 acute GVHD was associated with a higher risk of non-relapse and overall mortality than no acute GVHD, whereas grade 1-2 acute GVHD was associated with a lower risk of non-relapse and overall mortality than no acute GVHD. Limited or extensive chronic GVHD was significantly associated with a lower relapse rate. Limited chronic GVHD was associated with a lower overall and non-relapse mortality than no chronic GVHD. In conclusion, mild acute or chronic GVHD was associated not only with a low risk of relapse but also with a low risk of non-relapse mortality, and provides a survival benefit in UCBT.

Original language	English
Pages (from-to)	663-668
Number of pages	6
Journal	Leukemia
Volume	31
Issue number	3
DOIs	https://doi.org/10.1038/leu.2016.288
Publication status	Published - 2017 Mar 1
Externally published	Yes

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/leu.2016.288

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Kanda, J., Morishima, Y., Terakura, S., Wake, A., Uchida, N., Takahashi, S., Ono, Y., Onishi, Y., Kanamori, H., Aotsuka, N., Ozawa, Y., Ogawa, H., Sakura, T., Ohashi, K., Ichinohe, T., Kato, K., Atsuta, Y., Teshima, T., & Murata, M. (2017). Impact of graft-versus-host disease on outcomes after unrelated cord blood transplantation. Leukemia, 31(3), 663-668. https://doi.org/10.1038/leu.2016.288

Kanda, J, Morishima, Y, Terakura, S, Wake, A, Uchida, N, Takahashi, S, Ono, Y, Onishi, Y, Kanamori, H, Aotsuka, N, Ozawa, Y, Ogawa, H, Sakura, T, Ohashi, K, Ichinohe, T, Kato, K, Atsuta, Y, Teshima, T & Murata, M 2017, 'Impact of graft-versus-host disease on outcomes after unrelated cord blood transplantation', Leukemia, vol. 31, no. 3, pp. 663-668. https://doi.org/10.1038/leu.2016.288

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abstract = "The effect of graft-versus-host disease (GVHD) on transplant outcomes after unrelated cord blood transplantation (UCBT) has not been fully elucidated. We analyzed the impact of acute and chronic GVHD on outcomes in adult patients with acute leukemia or myelodysplastic syndrome who underwent their first UCBT (n=2558). The effect of GVHD on outcomes was analyzed after adjusting for other significant variables. The occurrence of GVHD was treated as a time-dependent covariate. The occurrence of grade 1-2 or 3-4 acute GVHD was significantly associated with a lower relapse rate. Grade 3-4 acute GVHD was associated with a higher risk of non-relapse and overall mortality than no acute GVHD, whereas grade 1-2 acute GVHD was associated with a lower risk of non-relapse and overall mortality than no acute GVHD. Limited or extensive chronic GVHD was significantly associated with a lower relapse rate. Limited chronic GVHD was associated with a lower overall and non-relapse mortality than no chronic GVHD. In conclusion, mild acute or chronic GVHD was associated not only with a low risk of relapse but also with a low risk of non-relapse mortality, and provides a survival benefit in UCBT.",

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AU - Takahashi, S.

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AB - The effect of graft-versus-host disease (GVHD) on transplant outcomes after unrelated cord blood transplantation (UCBT) has not been fully elucidated. We analyzed the impact of acute and chronic GVHD on outcomes in adult patients with acute leukemia or myelodysplastic syndrome who underwent their first UCBT (n=2558). The effect of GVHD on outcomes was analyzed after adjusting for other significant variables. The occurrence of GVHD was treated as a time-dependent covariate. The occurrence of grade 1-2 or 3-4 acute GVHD was significantly associated with a lower relapse rate. Grade 3-4 acute GVHD was associated with a higher risk of non-relapse and overall mortality than no acute GVHD, whereas grade 1-2 acute GVHD was associated with a lower risk of non-relapse and overall mortality than no acute GVHD. Limited or extensive chronic GVHD was significantly associated with a lower relapse rate. Limited chronic GVHD was associated with a lower overall and non-relapse mortality than no chronic GVHD. In conclusion, mild acute or chronic GVHD was associated not only with a low risk of relapse but also with a low risk of non-relapse mortality, and provides a survival benefit in UCBT.

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Impact of graft-versus-host disease on outcomes after unrelated cord blood transplantation

Abstract

ASJC Scopus subject areas

UN SDGs

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