Impact of recipient statin treatment on graft-versus-host disease after allogeneic hematopoietic cell transplantation.

Publication Type:

Journal Article

Source:

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, Volume 16, Issue 10, p.1463-6 (2010)

Keywords:

2010, Adult, Aged, Center-Authored Paper, Chronic Disease, Clinical Research Division, Cyclosporine, Drug Interactions, Female, Graft vs Host Disease, Graft vs Tumor Effect, Hematologic Neoplasms, hematopoietic stem cell transplantation, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Immunosuppressive Agents, Incidence, Male, Middle Aged, RECURRENCE, Research Trials Office Core Facility - Biostatistics Service, Retrospective Studies, RISK, Shared Resources, T-Lymphocytes, Transplantation, Homologous, Young Adult

Abstract:

We retrospectively analyzed outcomes among 1206 patients with hematologic malignancies who had hematopoietic cell transplantation (HCT) from HLA-identical siblings (n = 630) or HLA-matched unrelated donors (n = 576) at a single institution between 2001 and 2007 for a correlation between recipient statin use and risk of graft-versus-host disease (GVHD). Among recipients with cyclosporine-based postgrafting immunosuppression (n = 821), statin use at the time of transplant (6%) was associated with a decreased risk of extensive chronic GVHD (cGVHD) (multivariate hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.4-1.0; P = .05) and an increased risk of recurrent malignancy (HR, 1.75; 95% CI, 1.0-3.0; P = .04). Recipient statin use, however, had no apparent impact on the risks of cGVHD and recurrent malignancy among recipients given tacrolimus-based immunosuppression (n = 385; 8% statin treated). Risks of acute GVHD, nonrelapse mortality, and overall mortality were not significantly affected by recipient statin use. Hence, recipient statin treatment at the time of allogeneic HCT may decrease the risk of cGVHD in patients with cyclosporine-based immunosuppression, but at the expense of a compromised graft-versus-tumor effect.