TY - JOUR
T1 - New autoimmune diseases after cord blood transplantation: a retrospective study of EUROCORD and the Autoimmune Disease Working Party of the European Group for Blood and Marrow Transplantation
AU - Daikeler, Thomas
AU - Labopin, Myriam
AU - Ruggeri, Annalisa
AU - Crotta, Alessandro
AU - Abinun, Mario
AU - Hussein, Ayad Ahmed
AU - Carlson, Kristina
AU - Cornillon, Jérôme
AU - Diez-Martin, Jose L.
AU - Gandemer, Virginie
AU - Faraci, Maura
AU - Lindemans, Caroline
AU - O'Meara, Anne
AU - Mialou, Valerie
AU - Renard, Marleen
AU - Sedlacek, Petr
AU - Sirvent, Anne
AU - Socié, Gérard
AU - Sora', Federica
AU - Varotto, Stefania
AU - Sanz, Jaime
AU - Voswinkel, Jan
AU - Vora, Ajay
AU - Yesilipek, M. Akif
AU - Herr, Andree-Laure
AU - Gluckman, Eliane
AU - Farge, Dominique
AU - Rocha, Vanderson
PY - 2012
Y1 - 2012
N2 - To describe the incidence, risk factors, and treatment of autoimmune diseases (ADs) occurring after cord blood transplantation (CBT), we analyzed both CBT recipients reported to EUROCORD who had developed at least 1 new AD and those who had not. Fifty-two of 726 reported patients developed at least 1 AD within 212 days (range, 27-4267) after CBT. Cumulative incidence of ADs after CBT was 5.0% ± 1% at 1 year and 6.6% ± 1% at 5 years. Patients developing ADs were younger and had more nonmalignant diseases (P < .001). ADs target hematopoietic (autoimmune hemolytic anemia, n = 20; Evans syndrome, n = 9; autoimmune thrombocytopenia, n = 11; and immune neutropenia, n = 1) and other tissues (thyroiditis, n = 3; psoriasis, n = 2; Graves disease, n = 1; membranous glomerulonephritis, n = 2; rheumatoid arthritis, n = 1; ulcerative colitis, n = 1; and systemic lupus erythematosus, n = 1). Four patients developed 2 ADs (3 cases of immune thrombocytopenia followed by autoimmune hemolytic anemia and 1 Evans syndrome with rheumatoid arthritis). By multivariate analysis, the main risk factor for developing an AD was nonmalignant disease as an indication for CBT (P = .0001). Hematologic ADs were most often treated with steroids, rituximab, and cyclosporine. With a median follow-up of 26 months (range, 2-91), 6 of 52 patients died as a consequence of ADs. We conclude that CBT may be followed by potentially life-threatening, mainly hematologic ADs.
AB - To describe the incidence, risk factors, and treatment of autoimmune diseases (ADs) occurring after cord blood transplantation (CBT), we analyzed both CBT recipients reported to EUROCORD who had developed at least 1 new AD and those who had not. Fifty-two of 726 reported patients developed at least 1 AD within 212 days (range, 27-4267) after CBT. Cumulative incidence of ADs after CBT was 5.0% ± 1% at 1 year and 6.6% ± 1% at 5 years. Patients developing ADs were younger and had more nonmalignant diseases (P < .001). ADs target hematopoietic (autoimmune hemolytic anemia, n = 20; Evans syndrome, n = 9; autoimmune thrombocytopenia, n = 11; and immune neutropenia, n = 1) and other tissues (thyroiditis, n = 3; psoriasis, n = 2; Graves disease, n = 1; membranous glomerulonephritis, n = 2; rheumatoid arthritis, n = 1; ulcerative colitis, n = 1; and systemic lupus erythematosus, n = 1). Four patients developed 2 ADs (3 cases of immune thrombocytopenia followed by autoimmune hemolytic anemia and 1 Evans syndrome with rheumatoid arthritis). By multivariate analysis, the main risk factor for developing an AD was nonmalignant disease as an indication for CBT (P = .0001). Hematologic ADs were most often treated with steroids, rituximab, and cyclosporine. With a median follow-up of 26 months (range, 2-91), 6 of 52 patients died as a consequence of ADs. We conclude that CBT may be followed by potentially life-threatening, mainly hematologic ADs.
KW - autoimmune diseases
KW - cord blood transplantation
KW - autoimmune diseases
KW - cord blood transplantation
UR - http://hdl.handle.net/10807/39946
U2 - 10.1182/blood-2012-07-445965
DO - 10.1182/blood-2012-07-445965
M3 - Article
SN - 1528-0020
VL - 121
SP - 1059
EP - 1064
JO - Blood
JF - Blood
ER -