Clinical factors predicting the response of acute graft-versus-host disease to corticosteroid therapy: An analysis from the gvhd working group of the Japan society for hematopoietic cell transplantation

Makoto Murata, Hideki Nakasone, Junya Kanda, Takahiko Nakane, Tatsuo Furukawa, Takahiro Fukuda, Takehiko Mori, Shuichi Taniguchi, Tetsuya Eto, Kazuteru Ohashi, Masayuki Hino, Masami Inoue, Hiroyasu Ogawa, Yoshiko Atsuta, Tokiko Nagamura-Inoue, Hiromasa Yabe, Yasuo Morishima, Hisashi Sakamaki, Ritsuro Suzuki

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Systemic corticosteroid therapy is recommended as a first-line treatment for acute graft-versus-host disease (GVHD). We performed a retrospective study to identify the factors affecting the response of grade II to IV acute GVHD to systemic corticosteroid therapy using the Japanese national registry data for patients who received first allogeneic hematopoietic cell transplantation with bone marrow (BM) (n=1955), peripheral blood stem cells (PBSCs) (n=642), or umbilical cord blood (UCB) (n=839). Of 3436 patients, 2190 (63.7%) showed improvement of acute GVHD to first-line therapy with corticosteroids. Various factors were identified to predict corticosteroid response. Interestingly, UCB (versus HLA-matched related BM) transplantation was significantly associated with a higher probability of improvement, whereas HLA-matched unrelated BM and HLA-mismatched stem cell sources other than UCB were significantly associated with a lower probability of improvement. HLA-matched related PBSC transplantation was not significantly different from HLA-matched related BM transplantation. Patients without improvement from corticosteroid therapy had a 2.5-times higher nonrelapse mortality and a .6-times lower overall survival rate. The present study demonstrated, for the first time, a higher probability of improvement in grade II to IV acute GVHD with systemic corticosteroid therapy in patients after UCB transplantation than in those after BM and PBSC transplantation. A prospective study is warranted.

Original languageEnglish
Pages (from-to)1183-1189
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number8
DOIs
Publication statusPublished - 2013 Aug 1

Keywords

  • Acute graft-versus-host disease
  • Cord blood transplantation
  • Corticosteroid

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Murata, M., Nakasone, H., Kanda, J., Nakane, T., Furukawa, T., Fukuda, T., Mori, T., Taniguchi, S., Eto, T., Ohashi, K., Hino, M., Inoue, M., Ogawa, H., Atsuta, Y., Nagamura-Inoue, T., Yabe, H., Morishima, Y., Sakamaki, H., & Suzuki, R. (2013). Clinical factors predicting the response of acute graft-versus-host disease to corticosteroid therapy: An analysis from the gvhd working group of the Japan society for hematopoietic cell transplantation. Biology of Blood and Marrow Transplantation, 19(8), 1183-1189. https://doi.org/10.1016/j.bbmt.2013.05.003