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Graft-Versus-Host Disease

Chronic GVHD is associated with inferior relapse risk irrespective of stem cell source among patients receiving transplantation from unrelated donors

Bone Marrow Transplantation volume 47, pages 1474–1478 (2012)Cite this article

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Abstract

Chronic GVHD (cGVHD) has been associated with reduced risk of relapse after allo-SCT for onco-hematological disease due to a graft-vs-malignancy effect. Here we retrospectively analyzed a series of 802 adult patients transplanted from unrelated donors and found that cGVHD was associated with significantly lower relapse and that the limited form was associated with a survival advantage: hazard ratio for OS=0.63 (0.46–0.87); P=0.004; this was due to combination of relapse reduction and similar non-relapse mortality with respect to patients without cGVHD. Importantly, the graft-vs-malignancy effect observed here did not differ when PBSC or BM were used as stem cell source, thus suggesting that the protective effect of limited cGVHD is similar after PBSC- or BM-based transplantation. These findings could have practical implications and suggest no qualitative difference between cGVHD occurring after transplantation performed with different stem cell sources.

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Acknowledgements

The following institutions (GITMO centers) contributed to the study: Division of Hematology, Ospedale ‘SS Antonio e Biagio’ Alessandria (A Levis); Division of Hematology, Nuovo Ospedale ‘Torrette’ Ancona (P Leoni); Division of Hematology, Ospedali Riuniti, Bergamo (A Rambaldi); Institute of Hematology and Clinical Oncology ‘L A Seragnoli,’ Ospedale ‘S Orsola-Malpighi,’ University of Bologna, Bologna (G Bandini and F Bonifazi); Department of Hematology, Ospedale Regionale, Bolzano (M Casini); Division of Hematology and Bone Marrow Transplantation Center, Ospedale Oncologico ‘A Businco,’ Cagliari (E Angelucci and D Baronciani); Bone Marrow Transplantation Unit, Ospedale ‘R Binagli,’ University of Cagliari, Cagliari (G La Nasa); Division of Hematology and Bone Marrow Transplantation, Ospedale ‘Ferrarotto,’ Catania (G Milone); Division of Hematology, Ospedale ‘S Croce e Carlo,’ Cuneo (N Mordini); Department of Hematology, Ospedale ‘Careggi,’ University of Florence, Firenze (S Guidi and A Bosi); Division of Hematology, Ospedale ‘S Martino,’ Genova (A Bacigalupo and M T Van Lint); Division of Hematology and Oncology, IRCCS ‘G Gaslini’, Genova (G Dini); Hematology–Bone Marrow Transplantation Unit, Istituto Nazionale dei Tumori, University of Milano, Milano (P Corradini and R Milani); Division of Hematology Ospedale ‘Cà Granda’ Niguarda, Milano (E Morra, P Marenco); Department of Hematology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano (G Lambretenghi Deliliers and F Onida); Hematology and Bone Marrow Transplantation Unit, S Raffaele Scientific Institute, Milano (F Ciceri and M Marcatti); Transplantation Unit Department of Oncology–Hematology, IRCCS Clinica Humanitas, Rozzano (L Castagna); Department of Oncology and Hematology University of Modena and Reggio Emilia, Modena (F Narni); Division of Hematology and Transplant Unit, Ospedale ‘S Gerardo,’ University of Milano-Bicocca, Monza (P Pioltelli), Division of Hematology, University of Napoli ‘Federico II’ Medical School, Napoli (C Selleri); Clinica Onco-Ematologica, University of Padova, Padova (L Zanesco); Division of Hematology and Transplant Unit, Ospedale ‘V Cervello,’ Palermo (R Scimè); Department of Oncology, Hematology Unit, Ospedale ‘La Maddalena,’ Palermo (M Musso); Division of Hematology, University of Pavia, Fondazione IRCCS Policlinico ‘S Matteo,’ Pavia (EP Alessandrino); Pediatric Hematology–Oncology University of Pavia, Fondazione IRCCS Policlinico ‘S Matteo,’ Pavia (F Locatelli); Hematology and Transplant Center, Ospedale ‘S Salvatore,’ Pesaro (G Visani); Department of Hematology, Ospedale Civile, Pescara (P Di Bartolomeo); Division of Hematology, University of Pisa, Pisa (F Papineschi); Division of Onco-Hematology, Azienda Ospedaliera Universitaria Pisana, Pisa (C Favre); Transplant Unit ‘A Neri,’ Ospedale ‘Bianchi-Melacrino-Morelli,’ Reggio Calabria (G Messina); Division of Hematology, Department of Cellular Biotechnologies and Hematology, University ‘La Sapienza’ (A P Iori and R Foà); Hematology and Stem Cell Transplantation Unit Ospedale ‘S Camillo,’ Roma (A Locasciulli and I Majolino); Hematology, University ‘S Cuore,’ Roma (P Chiusolo and G Leone); Hemato-Oncology Transplant Unit, University ‘Tor Vergata,’ Roma (W Arcese and R Cerretti); Unit of Hematology and Bone Marrow Transplantation, IRCCS, ‘Casa Sollievo della Sofferenza,’ S Giovanni Rotondo (A M Carella and N Cascavilla); Division of Hematology and Bone Marrow Transplantation, Policlinico ‘Le Scotte’, Siena (F Lauria); Institute of Hematology, Ospedale Nord, Taranto (P Mazza); Division of Hematology, Ospedale ‘S Giovanni Battista,’ Torino (M Falda); Division of Hematology, University of Torino, Ospedale ‘S Giovanni Battista,’ Torino (B Bruno and M Boccadoro); Center of Stem Cell Transplantation and Cellular Therapy, Ospedale Infantile Regina Margherita, Torino (F Fagioli); Division of Hematology and Bone Marrow Transplantation, University of Udine, Udine (R Fanin and M Cerno); Division of Hematology-Bone Marrow Transplantation Unit, Policlinico ‘GB Rossi’, Verona (F Benedetti) and Department of Hematology, Ospedale ‘S Bortolo,’ Vicenza (R Raimondi).

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Authors and Affiliations

  1. Department of Health Sciences (DISSAL), Section of Biostatistic, University of Genoa, Genova, Italy

    A Signori, R Crocchiolo & M P Sormani

  2. Italian Group of Bone Marrow Transplantation (GITMO), Genova, Italy

    R Oneto, F Fagioli, A Rambaldi, F Ciceri & A Bacigalupo

  3. Italian Bone Marrow Donor Registry (IBMDR), Genova, Italy

    N Sacchi

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  1. A Signori
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  2. R Crocchiolo
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Correspondence to A Signori.

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Signori, A., Crocchiolo, R., Oneto, R. et al. Chronic GVHD is associated with inferior relapse risk irrespective of stem cell source among patients receiving transplantation from unrelated donors. Bone Marrow Transplant 47, 1474–1478 (2012). https://doi.org/10.1038/bmt.2012.58

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