The impact of GVHD on outcomes after adult single cord blood transplantation in European and Japanese populations

Junya Kanda; Hiromi Hayashi; Annalisa Ruggeri; Fumihiko Kimura; Fernanda Volt; Satoshi Takahashi; Shinichi Kako; Karina Tozatto-Maio; Masamitsu Yanada; Guillermo Sanz; Naoyuki Uchida; Emanuele Angelucci; Seiko Kato; Mohamad Mohty; Edouard Forcade; Masatsugu Tanaka; Jorge Sierra; Takanori Ohta; Riccardo Saccardi; Takahiro Fukuda; Tatsuo Ichinohe; Takafumi Kimura; Vanderson Rocha; Shinichiro Okamoto; Arnon Nagler; Yoshiko Atsuta; Eliane Gluckman

doi:10.1038/s41409-021-01479-4

The impact of GVHD on outcomes after adult single cord blood transplantation in European and Japanese populations

Bone Marrow Transplant. 2022 Jan;57(1):57-64. doi: 10.1038/s41409-021-01479-4. Epub 2021 Oct 11.

Authors

Junya Kanda¹, Hiromi Hayashi^{2

3

4}, Annalisa Ruggeri^{3

4

5}, Fumihiko Kimura⁶, Fernanda Volt^{3

4}, Satoshi Takahashi⁷, Shinichi Kako⁸, Karina Tozatto-Maio^{3

4

9}, Masamitsu Yanada¹⁰, Guillermo Sanz¹¹, Naoyuki Uchida¹², Emanuele Angelucci¹³, Seiko Kato¹⁴, Mohamad Mohty^{15

16}, Edouard Forcade¹⁷, Masatsugu Tanaka¹⁸, Jorge Sierra¹⁹, Takanori Ohta²⁰, Riccardo Saccardi²¹, Takahiro Fukuda²², Tatsuo Ichinohe²³, Takafumi Kimura²⁴, Vanderson Rocha^{3

4}, Shinichiro Okamoto²⁵, Arnon Nagler^{26

27}, Yoshiko Atsuta²⁸, Eliane Gluckman^{3

4}

Affiliations

¹ Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. jkanda16@kuhp.kyoto-u.ac.jp.
² Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
³ Eurocord, Hospital Saint Louis, AP-HP, IUH University Paris VII, Paris, France.
⁴ Monacord, Centre Scientifique de Monaco, Monaco, Monaco.
⁵ Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁶ Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan.
⁷ Division of Molecular Therapy, The Advanced Clinical Research Center The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
⁸ Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
⁹ Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil.
¹⁰ Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan.
¹¹ Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain & CIBERONC, Madrid, Spain.
¹² Department of Hematology, Toranomon Hospital, Tokyo, Japan.
¹³ Hematology and Transplant Center, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
¹⁴ Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
¹⁵ Service d'Hématologie Clinique et de Thérapie cellulaire, APHP, Hôpital Saint Antoine, Paris, France.
¹⁶ Sorbonne University, Paris, France.
¹⁷ CHU Bordeaux, service d'hematologie et therapie cellulaire, Bordeaux, France.
¹⁸ Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
¹⁹ Hospital Santa Creu i Sant Pau Hematology Department, Barcelona, Catalunya, Spain.
²⁰ Department of Internal Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
²¹ Azienda Ospedaliera Universitaria Careggi Cell Therapy and Transfusion Medicine Unit, Firenze, Italy.
²² Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
²³ Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
²⁴ Preparation Department, Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan.
²⁵ Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
²⁶ Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
²⁷ EBMT Data Office, Hôpital Saint Antoine, Paris, France.
²⁸ Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.

PMID: 34635798
DOI: 10.1038/s41409-021-01479-4

Abstract

The impact of GVHD and graft-versus-leukemia effect in unrelated cord blood transplantation (UCBT) is controversial. In the Eurocord/ALWP EBMT and JSTCT/JDCHCT collaborative study, we evaluated the impact of GVHD on UCBT outcomes in Japanese and European registries. A total of 3,690 adult patients with acute leukemia who received their first single UCBT were included. A multivariate analysis of overall survival (OS) revealed a positive impact of grade II acute GVHD compared with grade 0-I GVHD, in the Japanese cohort (hazard ratio (HR), 0.81; P = 0.001), and an adverse impact in the European cohort (HR, 1.37; P = 0.007). A negative impact of grade III-IV acute GVHD on OS was observed regardless of registries. In the analysis of relapse, a positive impact of grade II acutes GVHD compared with grade 0-I GVHD was observed only in the Japanese cohort, regardless of disease risk. The positive impact of limited chronic GVHD on OS was observed only in the Japanese cohort. In conclusion, a positive impact of mild GVHD after a single UCBT was observed only in the Japanese cohort. This could explain the ethnic difference in UCBT outcomes and might contribute to the preference usage of UCBT in Japan.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cord Blood Stem Cell Transplantation* / adverse effects
Graft vs Host Disease* / etiology
Hematopoietic Stem Cell Transplantation*
Humans
Japan
Leukemia, Myeloid, Acute*
Transplantation Conditioning