The impact of GVHD on outcomes after adult single cord blood transplantation in European and Japanese populations

Junya Kanda*, Hiromi Hayashi, Annalisa Ruggeri, Fumihiko Kimura, Fernanda Volt, Satoshi Takahashi, Shinichi Kako, Karina Tozatto-Maio, Masamitsu Yanada, Guillermo Sanz, Naoyuki Uchida, Emanuele Angelucci, Seiko Kato, Mohamad Mohty, Edouard Forcade, Masatsugu Tanaka, Jorge Sierra, Takanori Ohta, Riccardo Saccardi, Takahiro FukudaTatsuo Ichinohe, Takafumi Kimura, Vanderson Rocha, Shinichiro Okamoto, Arnon Nagler, Yoshiko Atsuta, Eliane Gluckman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

The impact of GVHD and graft-versus-leukemia effect in unrelated cord blood transplantation (UCBT) is controversial. In the Eurocord/ALWP EBMT and JSTCT/JDCHCT collaborative study, we evaluated the impact of GVHD on UCBT outcomes in Japanese and European registries. A total of 3,690 adult patients with acute leukemia who received their first single UCBT were included. A multivariate analysis of overall survival (OS) revealed a positive impact of grade II acute GVHD compared with grade 0-I GVHD, in the Japanese cohort (hazard ratio (HR), 0.81; P = 0.001), and an adverse impact in the European cohort (HR, 1.37; P = 0.007). A negative impact of grade III-IV acute GVHD on OS was observed regardless of registries. In the analysis of relapse, a positive impact of grade II acutes GVHD compared with grade 0–I GVHD was observed only in the Japanese cohort, regardless of disease risk. The positive impact of limited chronic GVHD on OS was observed only in the Japanese cohort. In conclusion, a positive impact of mild GVHD after a single UCBT was observed only in the Japanese cohort. This could explain the ethnic difference in UCBT outcomes and might contribute to the preference usage of UCBT in Japan.

Original languageEnglish
Pages (from-to)57-64
Number of pages8
JournalBone Marrow Transplantation
Volume57
Issue number1
DOIs
StatePublished - Jan 2022
Externally publishedYes

Funding

FundersFunder number
Japan Agency for Medical Research and Development
Japan Society for the Promotion of Science21K08391, 18K08325
Japan Society for the Promotion of Science

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