Chronic graft-versus-host disease following umbilical cord blood transplantation: retrospective survey involving 1072 patients in Japan.

We have little information on chronic graft-versus-host disease (GVHD) after cord blood transplantation (CBT). We investigated its clinical features in 1072 Japanese patients with hematologic malignancies who received a transplant through the Japan Cord Blood Bank Network. The primary end point was to investigate the incidence of any chronic GVHD. Median age of the patients was 33 years (range, 0-79 years). The cumulative incidence of chronic GVHD 2 years after transplantation was 28%. Chronic GVHD was fatal in 29 patients. Multivariate analysis demonstrated that development of chronic GVHD was favorably associated with both overall survival and event-free survival. Multivariate analysis identified risk factors of chronic GVHD: higher patient body weight, higher number of mismatched antigens for GVHD direction, myeloablative preparative regimen, use of mycophenolate mofetil in GVHD prophylaxis, and development of grades II to IV acute GVHD. Although chronic GVHD is a significant problem after CBT, it is associated with improved survival, perhaps due to graft-versus-malignancy effects.

[1]  J. Wagner,et al.  Chronic graft-versus-host disease (cGVHD) following unrelated donor hematopoietic stem cell transplantation (HSCT): higher response rate in recipients of unrelated donor (URD) umbilical cord blood (UCB). , 2007, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[2]  S. Pavletic,et al.  Chronic graft-versus-host disease in the era of reduced-intensity conditioning , 2007, Leukemia.

[3]  Y. Kodera,et al.  Risk and prognostic factors for Japanese patients with chronic graft-versus-host disease after bone marrow transplantation , 2006, Bone Marrow Transplantation.

[4]  M. Turner,et al.  National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. , 2005, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[5]  J. Wagner,et al.  Outcomes after transplantation of cord blood or bone marrow from unrelated donors in adults with leukemia. , 2004, The New England journal of medicine.

[6]  M. Labopin,et al.  Transplants of umbilical-cord blood or bone marrow from unrelated donors in adults with acute leukemia. , 2004, The New England journal of medicine.

[7]  J. Bourhis,et al.  Chronic graft-versus-host disease after allogeneic blood stem cell transplantation: long-term results of a randomized study. , 2002, Blood.

[8]  R. Storb,et al.  Comparison of chronic graft-versus-host disease after transplantation of peripheral blood stem cells versus bone marrow in allogeneic recipients: long-term follow-up of a randomized trial. , 2002, Blood.

[9]  H. Deeg,et al.  Therapy for chronic graft-versus-host disease: a randomized trial comparing cyclosporine plus prednisone versus prednisone alone. , 2002, Blood.

[10]  H. Inoko,et al.  The clinical significance of human leukocyte antigen (HLA) allele compatibility in patients receiving a marrow transplant from serologically HLA-A, HLA-B, and HLA-DR matched unrelated donors. , 2002, Blood.

[11]  B. Haynes,et al.  A comparison of murine T-cell-depleted adult bone marrow and full-term fetal blood cells in hematopoietic engraftment and immune reconstitution. , 2002, Blood.

[12]  K. Cleary,et al.  Chronic graft-versus-host disease after allogeneic blood stem cell transplantation. , 2001, Blood.

[13]  D. Paniagua,et al.  Acute and chronic graft-versus-host disease after allogeneic peripheral-blood stem-cell and bone marrow transplantation: a meta-analysis. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[14]  J. Wagner,et al.  Hematopoietic engraftment and survival in adult recipients of umbilical-cord blood from unrelated donors. , 2001, The New England journal of medicine.

[15]  J. Adamson,et al.  Outcomes among 562 recipients of placental-blood transplants from unrelated donors. , 1998, The New England journal of medicine.

[16]  China. State Statistical Bureau.  Statistics on China's 1996 social development. , 1997, China population today.

[17]  O. Ringdén.  Bone marrow transplantation using unrelated donors for haematological malignancies , 1997, Medical oncology.

[18]  E D Thomas,et al.  1994 Consensus Conference on Acute GVHD Grading. , 1995, Bone marrow transplantation.

[19]  K. Sullivan,et al.  The management of chronic graft-versus-host disease. , 1994, Blood reviews.

[20]  K. Sullivan,et al.  Chronic graft-versus-host disease and other late complications of bone marrow transplantation. , 1991, Seminars in hematology.

[21]  A. Rimm,et al.  Graft-versus-leukemia reactions after bone marrow transplantation. , 1990, Blood.

[22]  Jean E. Sanders,et al.  Prednisone and azathioprine compared with prednisone and placebo for treatment of chronic graft-v-host disease: prognostic influence of prolonged thrombocytopenia after allogeneic marrow transplantation. , 1988, Blood.

[23]  H. Deeg,et al.  Alternating-day cyclosporine and prednisone for treatment of high-risk chronic graft-v-host disease. , 1988, Blood.