scholarly journals Higher Dose of Mycophenolate Mofetil Reduces Acute Graft-versus-Host Disease in Reduced-Intensity Conditioning Double Umbilical Cord Blood Transplantation

2015 ◽  
Vol 21 (5) ◽  
pp. 926-933 ◽  
Author(s):  
Nelli Bejanyan ◽  
John Rogosheske ◽  
Todd DeFor ◽  
Aleksandr Lazaryan ◽  
Kelli Esbaum ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Graft Versus Host Disease ◽  
Umbilical Cord Blood ◽  
Cord Blood Transplantation ◽  
Umbilical Cord Blood Transplantation ◽  
Reduced Intensity Conditioning ◽  
Graft Versus Host ◽  
Blood Transplantation ◽  
Reduced Intensity ◽  
Acute Graft

scholarly journals Acute graft-versus-host disease after unrelated donor umbilical cord blood transplantation: analysis of risk factors

Blood ◽  
2009 ◽  
Vol 113 (11) ◽  
pp. 2410-2415 ◽  
Author(s):  
Margaret L. MacMillan ◽  
Daniel J. Weisdorf ◽  
Claudio G. Brunstein ◽  
Qing Cao ◽  
Todd E. DeFor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Graft Versus Host Disease ◽  
Umbilical Cord Blood ◽  
Acute Gvhd ◽  
Cord Blood Transplantation ◽  
Umbilical Cord Blood Transplantation ◽  
Graft Versus Host ◽  
Blood Transplantation ◽  
Grade Ii ◽  
Acute Graft

Acute graft-versus-host disease (GVHD) occurs less frequently after umbilical cord blood transplantation (UCBT). More recent investigations include the use of 2 partially human leukocyte antigen (HLA)–matched UCB units, or double UCB graft, to meet the minimum cell-dose requirement. The purpose of this analysis was to assess the relative risk of acute GVHD in 265 consecutive patients receiving transplants with UCB graft composed of 1 (n = 80) or 2 (n = 185) units. The incidence of grade III-IV acute GVHD was similar between cohorts. However, the incidence of grade II-IV acute GVHD was higher among double UCBT recipients (58 vs 39%, P < .01). Three risk factors for grade II-IV acute GVHD were identified in multiple regression analysis: use of 2 UCB units, use of nonmyeloablative conditioning, and absence of antithymocyte globulin in the conditioning regimen. Transplantation-related mortality (TRM) at 1 year, however, was significantly lower after double UCBT (24 vs 39%, P = .02) even if recipients had grade II-IV acute GVHD (20 vs 39%, P = .05). These data suggest that, despite a higher incidence of grade II acute GVHD in recipients of 2 partially HLA-matched UCB units, there is no adverse effect on TRM. This study is registered at http://www.clinicaltrials.gov under the identifiers NCT00305682 and NCT00309842.

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