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

Bone Marrow Transplantation volume 57, pages 57–64 (2022)Cite this article

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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.

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Fig. 1: Impact of acute GVHD on overall survival and leukemia-free survival.
Fig. 2: Impact of chronic GVHD on overall survival and leukemia-free survival.

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Acknowledgements

This work was supported in part by the practical research project for allergic diseases and immunology (Research Technology of Medical Transplantation) from the Japan Agency for Medical Research and Development, AMED (YA and JK), and JSPS KAKENHI Grant Number 18K08325 and 21K08391 (JK).

Author information

Authors and Affiliations

  1. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Junya Kanda & Hiromi Hayashi

  2. Eurocord, Hospital Saint Louis, AP-HP, IUH University Paris VII, Paris, France

    Hiromi Hayashi, Annalisa Ruggeri, Fernanda Volt, Karina Tozatto-Maio, Vanderson Rocha & Eliane Gluckman

  3. Monacord, Centre Scientifique de Monaco, Monaco, Monaco

    Hiromi Hayashi, Annalisa Ruggeri, Fernanda Volt, Karina Tozatto-Maio, Vanderson Rocha & Eliane Gluckman

  4. Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Annalisa Ruggeri

  5. Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan

    Fumihiko Kimura

  6. Division of Molecular Therapy, The Advanced Clinical Research Center The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Satoshi Takahashi

  7. Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Shinichi Kako

  8. Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil

    Karina Tozatto-Maio

  9. Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan

    Masamitsu Yanada

  10. Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain & CIBERONC, Madrid, Spain

    Guillermo Sanz

  11. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    Naoyuki Uchida

  12. Hematology and Transplant Center, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Emanuele Angelucci

  13. Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Seiko Kato

  14. Service d’Hématologie Clinique et de Thérapie cellulaire, APHP, Hôpital Saint Antoine, Paris, France

    Mohamad Mohty

  15. Sorbonne University, Paris, France

    Mohamad Mohty

  16. CHU Bordeaux, service d’hematologie et therapie cellulaire, Bordeaux, France

    Edouard Forcade

  17. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan

    Masatsugu Tanaka

  18. Hospital Santa Creu i Sant Pau Hematology Department, Barcelona, Catalunya, Spain

    Jorge Sierra

  19. Department of Internal Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan

    Takanori Ohta

  20. Azienda Ospedaliera Universitaria Careggi Cell Therapy and Transfusion Medicine Unit, Firenze, Italy

    Riccardo Saccardi

  21. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  22. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  23. Preparation Department, Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan

    Takafumi Kimura

  24. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Shinichiro Okamoto

  25. Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel

    Arnon Nagler

  26. EBMT Data Office, Hôpital Saint Antoine, Paris, France

    Arnon Nagler

  27. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

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  1. Junya Kanda
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  2. Hiromi Hayashi
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Contributions

JK, YA, and EG designed the research and organized the project. JK performed the statistical analysis, JK wrote the first draft and all other authors interpreted the data, critically reviewed the draft, and approved the final version for publication.

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Correspondence to Junya Kanda.

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Kanda, J., Hayashi, H., Ruggeri, A. et al. The impact of GVHD on outcomes after adult single cord blood transplantation in European and Japanese populations. Bone Marrow Transplant 57, 57–64 (2022). https://doi.org/10.1038/s41409-021-01479-4

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