Donor statin treatment protects against severe acute graft-versus-host disease after related allogeneic hematopoietic cell transplantation.

Abstract

We retrospectively analyzed outcomes among 567 patients with hematologic malignancies who had hematopoietic cell transplantation from human leukocyte antigen-identical sibling donors between 2001 and 2007 for a correlation between statin use and risk of graft-versus-host disease (GVHD). Compared with allografts where neither the donor nor recipient was treated with a statin at the time of transplantation (n = 464), statin use by the donor and not the recipient (n = 75) was associated with a decreased risk of grade 3-4 acute GVHD (multivariate hazard ratio, 0.28; 95% confidence interval, 0.1-0.9). Statin use by both donor and recipient (n = 12) was suggestively associated with a decreased risk of grade 3 or 4 acute GVHD (multivariate hazard ratio, 0.00; 95% confidence interval, undefined), whereas statin use by the recipient and not the donor (n = 16) did not confer GVHD protection. Risks of chronic GVHD, recurrent malignancy, nonrelapse mortality, and overall mortality were not significantly affected by donor or recipient statin exposure. Statin-associated GVHD protection was restricted to recipients with cyclosporine-based postgrafting immunosuppression and was not observed among those given tacrolimus (P = .009). These results suggest that donor statin treatment may be a promising strategy to prevent severe acute GVHD without compromising immunologic control of the underlying malignancy.

• Authors: Marcello Rotta, Barry E Storer, Rainer F Storb, Paul J Martin, Shelly Heimfeld, Amanda Peffer, David G Maloney, H Joachim Deeg, Brenda M Sandmaier, Frederick R Appelbaum, Marco Mielcarek
• Journal: Blood (Blood) Vol. 115 Issue 6 Pg. 1288-95 (Feb 11 2010) ISSN: 1528-0020 [Electronic] United States
• PMID: 19965630 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• HLA Antigens
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Immunosuppressive Agents

Topics

• Adult
• Aged
• Aged, 80 and over
• Female
• Graft Survival (drug effects)
• Graft vs Host Disease (etiology, mortality, prevention & control)
• HLA Antigens (metabolism)
• Hematologic Neoplasms (complications, therapy)
• Hematopoietic Stem Cell Transplantation
• Histocompatibility Testing
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Immunosuppressive Agents (pharmacology)
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Risk Factors
• Siblings
• Survival Rate
• Tissue Donors
• Transplantation Conditioning
• Transplantation, Homologous (adverse effects)
• Treatment Outcome
• Young Adult