Impact of stem cell source on secondary steroid for chronic GVHD after allogeneic hematopoietic cell transplantation.

IF 1.7 4区医学 Q3 HEMATOLOGY

International Journal of Hematology Pub Date : 2024-11-25 DOI:10.1007/s12185-024-03866-1

Kazuhiro Sanda, Shigeo Fuji, Yuma Tada, Yasuhiro Shingai, Hidenori Kasahara, Sayako Yuda, Takafumi Yokota, Jun Ishikawa

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引用次数: 0

Abstract

Inappropriate discontinuation of immunosuppressive drugs (ISD) following allogeneic hematopoietic cell transplantation (HCT) can lead to the development of chronic graft-versus-host disease (cGVHD) and necessitate the reintroduction of ISD. However, only a few studies have compared the discontinuation rates of secondary steroid for cGVHD between different stem cell sources. We retrospectively evaluated 191 patients who underwent HCT at our institution to determine the discontinuation rates of secondary steroids for cGVHD. 50 patients (26.7%) received secondary steroid for cGVHD. After additional steroid for cGVHD, the 2-year cumulative steroid discontinuation rates were 50.0%, 0%, 8.3%, 44.0%, and 40.0% for MSD, uPBSC, uBM, UCB, PTCy-haplo, respectively (P = 0.0313). Patients transplanted with uBM or uPBSC had significantly lower cumulative discontinuation rates of additional steroids for cGVHD compared to those transplanted with other stem cell sources (P < 0.001). Multivariate analysis indicated that the cumulative steroid discontinuation rate was significantly lower in uPBSC or uBM group compared to in MSD group (uPBSC, HR, 0.10; P = 0.024, uBM, HR, 0.13; P = 0.007). Therefore, careful steroid reduction or additional treatment for cGVHD is necessary in patients transplanted with uBM and uPBSC.

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干细胞来源对异体造血细胞移植后慢性GVHD继发性类固醇的影响。

异基因造血细胞移植（HCT）后不适当地停用免疫抑制剂（ISD），会导致慢性移植物抗宿主疾病（cGVHD）的发生，从而需要重新使用ISD。然而，只有少数研究比较了不同干细胞来源的cGVHD患者停止使用辅助类固醇的比例。我们对191名在本院接受造血干细胞移植的患者进行了回顾性评估，以确定因cGVHD而停用二次类固醇的比率。50名患者（26.7%）因cGVHD接受了二次类固醇治疗。追加类固醇治疗cGVHD后，MSD、uPBSC、uBM、UTCB、PTCy-haplo的2年累计类固醇停用率分别为50.0%、0%、8.3%、44.0%和40.0%（P = 0.0313）。与使用其他干细胞来源移植的患者相比，使用uBM或uPBSC移植的患者因cGVHD而停用额外类固醇的累积率明显较低（P = 0.0313）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Hematology 医学-血液学

CiteScore

3.90

自引率

4.80%

发文量

223

审稿时长

6 months

期刊介绍： The International Journal of Hematology, the official journal of the Japanese Society of Hematology, has a long history of publishing leading research in hematology. The journal comprises articles that contribute to progress in research not only in basic hematology but also in clinical hematology, aiming to cover all aspects of this field, namely, erythrocytes, leukocytes and hematopoiesis, hemostasis, thrombosis and vascular biology, hematological malignancies, transplantation, and cell therapy. The expanded [Progress in Hematology] section integrates such relevant fields as the cell biology of stem cells and cancer cells, and clinical research in inflammation, cancer, and thrombosis. Reports on results of clinical trials are also included, thus contributing to the aim of fostering communication among researchers in the growing field of modern hematology. The journal provides the best of up-to-date information on modern hematology, presenting readers with high-impact, original work focusing on pivotal issues.