Hematopoietic cell transplantation in chronic granulomatous disease: a study of 712 children and adults

. 2020 Sep 03 ; 136 (10) : 1201-1211.

Jazyk angličtina Země Spojené státy americké Médium print

Typ dokumentu časopisecké články, multicentrická studie

Perzistentní odkaz   https://www.medvik.cz/link/pmid32614953
Odkazy

PubMed 32614953
DOI 10.1182/blood.2020005590
PII: S0006-4971(20)61750-5
Knihovny.cz E-zdroje

Chronic granulomatous disease (CGD) is a primary immunodeficiency resulting in life-threatening infections and inflammatory complications. Allogeneic hematopoietic cell transplantation (allo-HCT) can cure the disease, but the indication to transplant remains controversial. We performed a retrospective multicenter study of 712 patients with CGD who underwent allo-HCT transplantation from March 1993 through December 2018. We studied 635 children (aged <18 years) and 77 adults. Median follow-up was 45 months. Median age at transplantation was 7 years (range, 0.1-48.6). Kaplan-Meier estimates of overall survival (OS) and event-free survival (EFS) at 3 years were 85.7% and 75.8%, respectively. In multivariate analysis, older age was associated with reduced survival and increased chronic graft-versus-host disease. Nevertheless, OS and EFS at 3 years for patients ≥18 years were 76% and 69%, respectively. Use of 1-antigen-mismatched donors was associated with reduced OS and EFS . No significant difference was found in OS, but a significantly reduced EFS was noted in the small group of patients who received a transplant from a donor with a >1 antigen mismatch. Choice of conditioning regimen did not influence OS or EFS. In summary, we report an excellent outcome after allo-HCT in CGD, with low incidence of graft failure and mortality in all ages. Older patients and recipients of 1-antigen-mismatched grafts had a less favorable outcome. Transplantation should be strongly considered at a younger age and particularly in the presence of a well-matched donor.

Bone Marrow Unit Department of Paediatric Hematology Central Manchester National Health Service Trust Manchester United Kingdom

Centre for Allogeneic Stem Cell Transplantation Karolinska University Hospital Huddinge Stockholm Sweden

Children's Cancer Research Institute St Anna Children's Hospital Vienna Austria

Clinic of Hematology University Hospital Zurich Switzerland

Department of Bone Marrow Transplantation Hadassah University Hospital Jerusalem Israel

Department of Clinical Immunology and Transplantation Jagiellonian University Medical College Transplantation Center University Children's Hospital Krakow Poland

Department of Hematology Royal Hospital for Children Glasgow United Kingdom

Department of Hematopoietic Stem Cell Transplantation Dmitry Rogachev National Medical Center of Pediatric Hematology Oncology and Immunology Moscow Russia

Department of Paediatric Hematology and Oncology University Hospital Motol Prague Czech Republic

Department of Paediatric Immunology Great North Children's Hospital Newcastle upon Tyne United Kingdom

Department of Pediatrics and Adolescent Medicine Faculty of Medicine University of Freiburg Freiburg Germany

Department of Pediatrics and Adolescent Medicine University Medical Center Ulm Ulm Germany

Department of Pediatrics UMC Utrecht University Utrecht Utrecht The Netherlands

Department Pediatric Hematology Oncology Hannover Medical University Hannover Germany

División of Pediatric Hematology and Oncology Department of Pediatrics Erciyes University Kayseri Turkey

Division of Pediatric Hematology and Oncology Medical Center Department of Pediatric Hematology Oncology and BMT Wroclaw Medical University Wroclaw Poland

Division of Pediatric Hematology Oncology and Stem Cell Transplantation Helsinki University Hospital Helsinki Finland

Division of Stem Cell Transplantation University Children's Hospital Eleonore Foundation Zurich Switzerland

Dr von Hauner Children's Hospital University Hospital Ludwig Maximilians Universität München Munich Germany

European Society for Blood and Marrow Transplantation Data Office Leiden Leiden The Netherlands

Great Ormond Street Hospital for Children London United Kingdom

Hospital Israelita Albert Einstein São Paulo Brazil

Instituto da Criança Hospital das Clínicas da Universidade de São Paulo São Paulo Brazil

Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico Bambino Gesù Rome Italy

Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht The Netherlands

Oncohematology and Bone Marrow Transplantation Unit Ospedale dei Bambini Brescia Italy

Pediatric BMT Centre Ege University Izmir Turkey

Pediatric Hematology Oncology Fondazione IRCCS Policlinico San Matteo Pavia Italy

Pediatric Hematology Oncology King Faisal Specialist Hospital and Research Centre Riyadh Saudi Arabia

Princess Maxima Center Utrecht The Netherlands

Translational and Clinical Research Institute Newcastle University Newcastle upon Tyne United Kingdom; and

Unité d'Immunologie et d'Hématologie Hôpital Necker Paris France

Willem Alexander Kinderziekenhuis Leiden University Medical Center Leiden The Netherlands

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