Graft Versus Host Disease Following HLA-Matched Sibling Donor Compared with Matched Related Donor for Hematopoietic Stem Cell Transplantation for the Treatment of Severe Combined Immunodeficiency Disease.
Cyclosporine
Graft versus host disease
Hematopoietic stem cell transplantation
Primary immunodeficiency diseases
Severe combined immunodeficiency
Journal
Journal of clinical immunology
ISSN: 1573-2592
Titre abrégé: J Clin Immunol
Pays: Netherlands
ID NLM: 8102137
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
30
09
2018
accepted:
21
04
2019
pubmed:
2
5
2019
medline:
20
6
2020
entrez:
2
5
2019
Statut:
ppublish
Résumé
One of the limiting factors for successful hematopoietic stem cell transplantation (HSCT) is graft versus host disease (GVHD). The EBMT/ESID guidelines for HSCT in severe combined immunodeficiency (SCID) recommend no GVHD prophylaxis for a matched sibling donor (MSD). To determine the risk of GVHD in MSD HSCT for SCID patients compared to matched related donor (MRD). This retrospective cohort study compares MSD with MRD and the outcome of GVHD in all SCID patients who underwent HSCT between 1993 and 2013. All statistical analyses were done using IBM SPSS statistics software. One hundred forty-five SCID patients underwent 152 HSCTs while 82 (54%) received GVHD prophylaxis. GVHD occurred in 48 patients (31.5%); 20/48 (42%) had GVHD prophylaxis compared to 28/48 (58%) that did not, P = 0.022. Acute GVHD occurred at a higher trend in MSD, 37/120 (30.8%), compared to MRD, 6/32 (18.8%), P = 0.17. We also analyzed the outcome according to the period of HSCT. The first period was 1993 to 2003, 48 HSCTs, 43 MSD, 5 MRD; all patients had GVHD prophylaxis, and there was no difference in GVHD. The second period was 2004 to 2013: of 104 HSCTs, 77 had MSD and 27 had MRD; GVHD prophylaxis was used in 22.1% of MSD and 63% of MRD, P = 0.000. GVHD was significantly higher in the MSD (40.2%) compared to MRD (18.5%) patients, P = 0.041. GVHD prophylaxis in MSD transplant should be considered in SCID patients.
Sections du résumé
BACKGROUND
One of the limiting factors for successful hematopoietic stem cell transplantation (HSCT) is graft versus host disease (GVHD). The EBMT/ESID guidelines for HSCT in severe combined immunodeficiency (SCID) recommend no GVHD prophylaxis for a matched sibling donor (MSD).
OBJECTIVE
To determine the risk of GVHD in MSD HSCT for SCID patients compared to matched related donor (MRD).
METHODS
This retrospective cohort study compares MSD with MRD and the outcome of GVHD in all SCID patients who underwent HSCT between 1993 and 2013. All statistical analyses were done using IBM SPSS statistics software.
RESULTS
One hundred forty-five SCID patients underwent 152 HSCTs while 82 (54%) received GVHD prophylaxis. GVHD occurred in 48 patients (31.5%); 20/48 (42%) had GVHD prophylaxis compared to 28/48 (58%) that did not, P = 0.022. Acute GVHD occurred at a higher trend in MSD, 37/120 (30.8%), compared to MRD, 6/32 (18.8%), P = 0.17. We also analyzed the outcome according to the period of HSCT. The first period was 1993 to 2003, 48 HSCTs, 43 MSD, 5 MRD; all patients had GVHD prophylaxis, and there was no difference in GVHD. The second period was 2004 to 2013: of 104 HSCTs, 77 had MSD and 27 had MRD; GVHD prophylaxis was used in 22.1% of MSD and 63% of MRD, P = 0.000. GVHD was significantly higher in the MSD (40.2%) compared to MRD (18.5%) patients, P = 0.041.
CONCLUSION
GVHD prophylaxis in MSD transplant should be considered in SCID patients.
Identifiants
pubmed: 31041574
doi: 10.1007/s10875-019-00634-3
pii: 10.1007/s10875-019-00634-3
doi:
Substances chimiques
HLA Antigens
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
414-420Références
N Engl J Med. 1999 Feb 18;340(7):508-16
pubmed: 10021471
Bone Marrow Transplant. 2001 Apr;27(7):703-9
pubmed: 11360109
Lancet. 2003 Feb 15;361(9357):553-60
pubmed: 12598139
Annu Rev Immunol. 2004;22:625-55
pubmed: 15032591
JAMA. 2006 Feb 1;295(5):508-18
pubmed: 16449616
Saudi Med J. 2007 Dec;28(12):1881-4
pubmed: 18060221
J Allergy Clin Immunol. 2008 Dec;122(6):1185-93
pubmed: 19084111
J Pediatr. 2009 Dec;155(6):834-840.e1
pubmed: 19818451
J Clin Immunol. 2013 Oct;33(7):1156-64
pubmed: 23818196
J Allergy Clin Immunol. 2014 Apr;133(4):1092-8
pubmed: 24290292
J Allergy Clin Immunol. 2014 Jun;133(6):1660-6
pubmed: 24794685
N Engl J Med. 2014 Jul 31;371(5):434-46
pubmed: 25075835
J Allergy Clin Immunol. 2014 Oct;134(4):935-943.e15
pubmed: 25109802
Curr Pediatr Rep. 2015 Mar 1;3(1):1-10
pubmed: 25821657
J Clin Immunol. 2015 Oct;35(7):651-60
pubmed: 26395454
Eur J Immunol. 2018 Feb;48(2):316-329
pubmed: 28944953
Bone Marrow Transplant. 1995 Jun;15(6):825-8
pubmed: 7581076