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

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.

• Authors: Marcello Rotta, Barry E Storer, Rainer Storb, Paul J Martin, Mary E D Flowers, Miwa S Vernon, Amanda Peffer, David G Maloney, H Joachim Deeg, Brenda M Sandmaier, Frederick R Appelbaum, Marco Mielcarek
• Journal: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (Biol Blood Marrow Transplant) Vol. 16 Issue 10 Pg. 1463-6 (Oct 2010) ISSN: 1523-6536 [Electronic] United States
• PMID: 20685260 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Immunosuppressive Agents
• Cyclosporine

Topics

• Adult
• Aged
• Chronic Disease
• Cyclosporine (therapeutic use)
• Drug Interactions
• Female
• Graft vs Host Disease (drug therapy, epidemiology, etiology, prevention & control)
• Graft vs Tumor Effect (drug effects)
• Hematologic Neoplasms (mortality, surgery)
• Hematopoietic Stem Cell Transplantation
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (adverse effects, pharmacology, therapeutic use)
• Immunosuppressive Agents (therapeutic use)
• Incidence
• Male
• Middle Aged
• Recurrence
• Retrospective Studies
• Risk
• T-Lymphocytes (drug effects)
• Transplantation, Homologous (adverse effects)
• Young Adult