Chronic graft-versus-host disease following umbilical cord blood transplantation: retrospective survey involving 1072 patients in Japan
Chronic graft-versus-host disease following umbilical cord blood transplantation: retrospective survey involving 1072 patients in Japan
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DOI：
10.1182/blood-2007-11-118893
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发表时间：
2008-09-15
期刊：
影响因子：
20.3
通讯作者：
Kato, Shunichi
中科院分区：
文献类型：
--
作者：
Narimatsu, Hiroto;Miyakoshi, Shigesaburo;Kato, Shunichi
我们对脐带血移植（CBT）后慢性移植物抗宿主病（GVHD）的信息很少。我们调查了1072例通过日本脐带血库网络接受移植的日本恶性血液病患者的临床特征。主要终点是调查任何慢性GVHD的发生率。患者的中位年龄为33岁（范围，0-79岁）。移植后2年慢性GVHD的累积发生率为28%。慢性GVHD在29例患者中是致命的。多因素分析表明，慢性GVHD的发展与总生存率和无事件生存率均呈正相关。多因素分析确定了慢性GVHD的危险因素：较高的患者体重，GVHD方向的错配抗原数量较多，清髓性准备方案，在GVHD预防中使用吗替麦考酚酯，以及II级至IV级急性GVHD的发展。虽然慢性GVHD是CBT后的一个重要问题，但它与生存率的提高有关，这可能是由于移植物抗恶性肿瘤效应。
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.