Faculty Collaboration Database

Atorvastatin for the Prophylaxis of Acute Graft-versus-Host Disease in Patients Undergoing HLA-Matched Related Donor Allogeneic Hematopoietic Stem Cell Transplantation (allo-HCT). Biol Blood Marrow Transplant 2016 Jan;22(1):71-9

Date

08/11/2015

Pubmed ID

26256940

Pubmed Central ID

PMC4706501

DOI

10.1016/j.bbmt.2015.07.034

Scopus ID

2-s2.0-84952637331 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

Statins possess potent immunomodulatory effects that may play a role in preventing acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic cell transplantation (allo-HCT). We performed a phase II study of atorvastatin for aGVHD prophylaxis when given to allo-HCT recipients and their HLA-matched sibling donors. Atorvastatin (40 mg/day) was administered to sibling donors, beginning 14 days before the anticipated start of stem cell collection. Allo-HCT recipients (n = 40) received atorvastatin (40 mg/day) in addition to standard aGVHD prophylaxis. The primary endpoint was cumulative incidence of grades II to IV aGVHD at day 100. Atorvastatin was well tolerated, with no attributable grades III to IV toxicities in donors or their recipients. Day 100 and 180 cumulative incidences of grades II to IV aGVHD were 30% (95% confidence interval [CI], 17% to 45%) and 40% (95% CI, 25% to 55%), respectively. One-year cumulative incidence of chronic GVHD was 43% (95% CI, 32% to 69%). One-year nonrelapse mortality and relapse incidences were 5.5% (95% CI, .9% to 16.5%) and 38% (95% CI, 18% to 47%), respectively. One-year progression-free and overall survival rates were 54% (95% CI, 38% to 71%) and 82% (95% CI, 69% to 94%). One-year GVHD-free, relapse-free survival was 27% (95% CI, 16% to 47%). These results did not differ from our historical control subjects (n = 96). Although safe and tolerable, the addition of atorvastatin did not appear to provide any benefit to standard GVHD prophylaxis alone.

Author List

Efebera YA, Geyer S, Andritsos L, Vasu S, Jaglowski S, Bingman A, Blum W, Klisovic R, Hofmeister CC, Benson DM, Penza S, Elder P, Cortright K, Kitzler R, Coombes K, O'Donnell L, Daneault B, Bradbury H, Zhang J, Chen X, Garman S, Ranganathan P, Yu X, Hofstetter J, Yu J, Garzon R, Scrape SR, Lozanski G, Devine SM

Author

Samantha M. Jaglowski MD, MPH Professor in the Medicine department at Medical College of Wisconsin

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

Acute Disease
Adult
Aged
Allografts
Disease-Free Survival
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Male
Middle Aged
Survival Rate
Tissue Donors