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Graft-versus-host disease and survival after cord blood transplantation for acute leukemia: a comparison of Japanese versus White populations. Biol Blood Marrow Transplant 2014 May;20(5):662-7 PMID: 24525277 PMCID: PMC4071962

Pubmed ID

24525277

DOI

10.1016/j.bbmt.2014.01.020

Abstract

An earlier report identified higher risks of acute and chronic graft-versus-host disease (GVHD) in White children compared with the Japanese after HLA-matched sibling transplantations. The current analysis explored whether racial differences are associated with GVHD risks after unrelated umbilical cord blood transplantation. Included are patients of Japanese descent (n = 257) and Whites (n = 260; 168 of 260 received antithymocyte globulin [ATG]). Transplants were performed in the United States or Japan between 2000 and 2009; patients were aged 16 years or younger, had acute leukemia, were in complete remission, and received a myeloablative conditioning regimen. The median ages of the Japanese and Whites who received ATG were younger at 5 years compared with 8 years for Whites who did not receive ATG. In all groups most transplants were mismatched at 1 or 2 HLA loci. Multivariate analysis found no differences in risks of acute GVHD between the Japanese and Whites. However, chronic GVHD was higher in Whites who did not receive ATG compared with the Japanese (hazard ratio, 2.16; P < .001), and treatment-related mortality was higher in Whites who received ATG compared with the Japanese (relative risk, 1.81; P = .01). Nevertheless, there were no significant differences in overall survival between the 3 groups.

Author List

Kuwatsuka Y, Atsuta Y, Horowitz MM, Inagaki J, Kanda J, Kato K, Koh K, Zhang MJ, Eapen M, Center for International Blood and Marrow Transplant Research (CIBMTR), and Donor/Source and GVHD Working Group of the Japan Society for Hematopoietic Cell Transplantation (JSHCT)

Authors

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-84897957526   14 Citations

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Antilymphocyte Serum
Asian Continental Ancestry Group
Child
Child, Preschool
Cord Blood Stem Cell Transplantation
European Continental Ancestry Group
Female
Graft vs Host Disease
Histocompatibility Testing
Humans
Infant
Leukemia
Male
Myeloablative Agonists
Survival Analysis
Transplantation Conditioning
Transplantation, Homologous
Unrelated Donors
jenkins-FCD Prod-331 a335b1a6d1e9c32173c9534e6f6ff51494143916