Abstract
Most reports of chronic GVHD after cord blood transplantation (CBT) have utilized traditional diagnostic criteria. We used traditional criteria and National Institutes of Health (NIH) criteria prospectively to evaluate chronic GVHD in a cohort of 87 adult and pediatric recipients of single or double unrelated CBT for treatment of hematologic malignancies. Fifty-four patients developed traditionally defined chronic GVHD, for an estimated 2-year probability of 64%. Among 54 patients, 25 (46%) met the NIH criteria for persistent, recurrent or late acute GVHD at onset. Twenty-four (44%) had overlap chronic GVHD, including one who presented initially with late acute GVHD, and only seven (13%) had classic chronic GVHD, including one who also presented initially with late acute GVHD. Among patients who successfully discontinued all systemic immunosuppression (SI), the median time to discontinuation of corticosteroid treatment was 315 days (range 28–977), and the median time to discontinuation of all SI was 353 days (range 67–977). Chronic GVHD diagnosed by traditional criteria after CBT had a predominance of acute GVHD clinical features.
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Acknowledgements
We thank MaryJoy Lopez for her invaluable assistance with the data collection. We thank Ivy Riffkin and the Cord Blood Transplant Team, and Carina Moravec and the staff of the Long-Term Follow-Up (LTFU) at the Fred Hutchinson Cancer Research Center for their long-term care of the patients and their assistance with the data collection. We are grateful to the patients and families who consented to participate in these clinical trials. This work was supported by in part by the NIH T32 HL007093, K23 HL077446, R24 HL74445 and CA18029, and by a research grant from Medac GmbH. CD is a Damon Runyan Clinical Investigator supported in part by the Damon Runyon Cancer Research Foundation (#CI 35-07).
Author contributions
LFN designed the study, collected the data, analyzed the data and wrote the paper. MEDF and CD designed the study, analyzed the data, and reviewed and edited the paper. TAG performed the statistical analysis and reviewed the paper. FM, PAC and PJM reviewed and edited the paper.
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Newell, L., Flowers, M., Gooley, T. et al. Characteristics of chronic GVHD after cord blood transplantation. Bone Marrow Transplant 48, 1285–1290 (2013). https://doi.org/10.1038/bmt.2013.48
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DOI: https://doi.org/10.1038/bmt.2013.48
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