1. Inicio
  2. Publicaciones
  3. Occurrence of graft-versus-host disease increases mortality after umbilical cord blood transplantation for acute myeloid leukaemia: a report from Eurocord and the ALWP of the EBMT

Occurrence of graft-versus-host disease increases mortality after umbilical cord blood transplantation for acute myeloid leukaemia: a report from Eurocord and the ALWP of the EBMT

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Baron, F
  • Ruggeri, A
  • Beohou, E
  • Labopin, M
  • Mohty, M
  • Vigouroux, S
  • Furst, S
  • Bosi, A
  • Chevallier, P
  • Cornelissen, JJ
  • Michallet, M
  • Sierra, J
  • Karakasis, D
  • Savani, BN
  • Gluckman, E
  • Nagler, A

Grupos

Abstract

BackgroundThe efficacy of umbilical cord blood transplantation (UCBT) as treatment for acute myeloid leukaemia (AML) relies on immune-mediated graft-versus-leukaemia effects. Previous studies have suggested a strong association between graft-versus-host disease (GVHD) occurrence and graft-versus-leukaemia effects after allogeneic hematopoietic cell transplantation. MethodsHere, we evaluated the kinetics of relapse rate in correlation with GVHD occurrence after UCBT. The kinetics of relapse rate over time in correlation to GVHD occurrence were assessed by calculating the relapse rate per patient-year within sequential 90-day intervals. The impact of GVHD on relapse and mortality was further studied in multivariate Cox models handling GVHD as a time-dependent covariate. ResultsThe study included data from 1068 patients given single (n=567) or double (n=501) UCBT. The proportion of patients with grade II, III and IV acute GVHD was 20%, 7% and 4%, respectively. At 2years, the cumulative incidence of chronic GVHD was 42%, the cumulative incidence of relapse was 32%, and overall survival was 32% as well. Relapse rates declined gradually over time during the first 30months after transplantation. There was a possible suggestion that grade II-IV acute (HR=0.8, P=0.1) and chronic (HR=0.65, P=0.1) GVHD decreased relapse risk. However, grade II-IV acute GVHD significantly increased early (the first 18months after UCBT) mortality (HR=1.3, P=0.02), whilst chronic GVHD increased each early (HR=2.7, P<0.001) and late (HR=4.9, P<0.001) mortality after UCBT. ConclusionsThe occurrence of grade II-IV acute or chronic GVHD each increases overall mortality after UCBT for AML mitigating the possible graft-versus-leukemia effect of GVHD.

Datos de la publicación

ISSN/ISSNe:
0954-6820, 1365-2796

JOURNAL OF INTERNAL MEDICINE  WILEY-BLACKWELL

Tipo:
Article
Páginas:
178-189
Factor de Impacto:
2,628 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 22

Documentos

  • No hay documentos

Métricas

Filiaciones mostrar / ocultar

Keywords

  • acute myeloid leukaemia; graft-versus-host disease; graft-versus-leukaemia effects; umbilical cord blood transplantation

Campos de estudio

Proyectos asociados

MECANISMOS DE ENFERMEDAD EN LA MIOCARDIOPATIA ARRITMOGENICA, MEJORAS EN SU DIAGNOSTICO Y BUSQUEDA DE DIANAS TERAPEUTICAS.

Investigador Principal: ESTHER ZORIO GRIMA

PI14/01477 . INSTITUTO DE SALUD CARLOS III . 2015

INCORPORACIÓN GRUPOS CIBER. DR. DOLZ

Investigador Principal: LUIS VICENTE MARTÍNEZ DOLZ

CB16/11/00261 . INSTITUTO DE SALUD CARLOS III . 2017

ESTUDIO MULTICÉNTRICO, ALEATORIZADO, DOBLE CIEGO, BASADO EN EVENTOS, QUE COMPARA LA EFICACIA Y SEGURIDAD DE RIVAROXABAN CON PLACEBO EN LA REDUCCIÓN DEL RIESGO DE MUERTE, INFARTO DE MIOCARDIO O ICTUS, EN PACIENTES CON INSUFICIENCIA CARDIACA Y ENFERMEDAD ARTERIAL CORONARIA SIGNIFICATIVA TRAS UN EPISODIO DE INSUFICIENCIA CARDIACA DESCOMPENSADA.

Investigador Principal: LUIS ALMENAR BONET

RIVAROXHFA3001/BAY59-7939/16302 . 2013

EVALUACIÓN, EN PACIENTES CON PROCESOS MÉDICOS, DE RIVAROXABAN FRENTE A PLACEBO EN LA REDUCCIÓN DEL RIESGO DE TROMBOEMBOLISMO VENOSO DESPUÉS DEL ALTA HOSPITALARIA. (MARINER).

Investigador Principal: JOSÉ ANTONIO TODOLÍ PARRA

RIVAROXDVT3002/BAY59-7939/17261

Cita

Compartir