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Biol Blood Marrow Transplant. 2016 Sep;22(9):1721-1724. doi: 10.1016/j.bbmt.2016.05.022. Epub 2016 May 28.

Influence of Previous Inflammatory Bowel Disease on the Outcome of Allogeneic Hematopoietic Stem Cell Transplantation: A Matched-Pair Analysis.

Author information

1
APHP, Hematology Transplantation, St. Louis Hospital, Paris, France.
2
APHP, Center for Clinical Epidemiology, Hôtel-Dieu Hospital, Paris, France.
3
CHRU de Strasbourg, Hematology, Hopital de Hautepierre, Strasbourg, France.
4
APHP, Hematology, Pitié Salpêtrière Hospital, Paris, France.
5
Hematology, CHU Bordeaux, Hopital Haut-Leveque, Pessac, France.
6
Department of Oncology Hematology and Cell Therapy, Poitiers University Hospital, Poitiers, France.
7
APHP, Hematology Adult Unit, Necker Hospital, Paris, France; Paris Descartes University, Paris, France.
8
Hematology, CHU Montpellier, St. Eloi Hospital, Montpelier, France.
9
APHP, Hematology Transplantation, St. Louis Hospital, Paris, France; Inserm UMR 1160, Paris, France; University Paris 7, Paris, France. Electronic address: gerard.socie@aphp.fr.

Abstract

The idiopathic inflammatory bowel diseases (IBDs) Crohn's disease and ulcerative colitis are associated with increased risk of hematologic malignancies. Allogeneic hematopoietic stem cell transplantation (HSCT) could be a curative strategy in this setting, but has been thought to be associated with increased nonrelapse mortality (NRM). We conducted a national French retrospective analysis of patients with IBD who underwent allogeneic HSCT for hematologic malignancies and were matched with 3 controls according to recipient, donor, and transplant characteristics. Between 2004 and 2015, 18 patients with IBD underwent allogeneic HSCT. With a median follow-up of 33 months for the patients with IBD and 57 months for controls, the cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) was 39% for the patients with IBD and 40% for controls (hazard ratio [HR], 1.10; P = .82). The cumulative incidence of chronic GVHD at 48 months was 52% for the patients with IBD and 43% for controls (HR, 0.92; P = .89). Nonrelapse mortality at 48 months was 19% for the patients with IBD and 11% for controls (HR, 4.93; P = .067). Overall survival at 48 months was 59% for the patients with IBD and 60% for matched controls (HR, 1.35; P = .56). In conclusion, IBD should not be considered a contraindication for transplantation, and its impact on comorbidity indexes should be reduced.

KEYWORDS:

Acute graft-versus-host disease; Allogeneic hematopoietic stem cell transplantation; Chronic graft-versus-host disease; Comorbidity index; Hematologic malignancies; Inflammatory bowel disease

PMID:
27246370
DOI:
10.1016/j.bbmt.2016.05.022
[Indexed for MEDLINE]
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