Format

Send to

Choose Destination
Haematologica. 2019 Oct 10. pii: haematol.2019.228668. doi: 10.3324/haematol.2019.228668. [Epub ahead of print]

Association of uric acid levels before start of conditioning with mortality after alloSCT: a prospective, non-interventional study of the EBMT Transplant Complication Working Party.

Author information

1
Charité Universitätsmedizin Berlin, Berlin, Germany; olaf.penack@charite.de.
2
EBMT Statistical Unit, Paris, France.
3
EBMT Data Office, Leiden, The Netherlands.
4
University of Freiburg, Freiburg, Germany.
5
Hannover Medical School, Hannover, Germany.
6
Department of Hematology, University Hospital Leuven and KU Leuven, Leuven, Belgium.
7
Imperial College, London, United Kingdom.
8
HUCH Comprehensive Cancer Center, Helsinki, Finland.
9
Antwerp University Hospital, Antwerp, Belgium.
10
Erciyes University Medical Faculty, Turkey.
11
Charité Universitätsmedizin Berlin, Berlin, Germany.
12
Radboud University - Nijmegen Medical Centre, Nijmegen, The Netherlands.
13
Hospital Santa Creu I Sant Pau, Barcelona, Spain.
14
Fondazione IRCCS - Ca Granda, Milan, Italy.
15
Universitätsklinikum Göttingen, Göttingen, Germany.
16
CHRU Limoges, Limoges, France.
17
Hospital Clinic, Barcelona, Spain.
18
Gazi University Faculty of Medicine, Ankara, Turkey.
19
Hospital Regional de Málaga, Malaga, Spain.
20
Instituto national do Cancer, Rio de Janeiro, Brazil.
21
Elisabethinen-Hospital, Linz, Austria.
22
LKH - University Hospital Graz, Graz, Austria.
23
Hospital Universitario Puerta de Hierro, Madrid, Spain.
24
Medical University of Warsaw, Warsaw, Poland.

Abstract

Uric acid is a danger signal contributing to inflammation. Its relevance to allogeneic stem cell transplantation derives from preclinical models where the depletion of uric acid led to improved survival and reduced graft-versus-host disease. In a clinical pilot trial, peri-transplant uric acid depletion reduced acute graft-versus-host disease incidence. This prospective international multicenter study aimed to investigate the association of uric acid serum levels before start of conditioning with allogeneic stem cell transplantation outcome. We included patients with acute leukemia, lymphoma or myelodysplastic syndrome receiving a first matched sibling allogeneic stem cell transplantation from peripheral blood, regardless of conditioning. We compared outcomes between patients with high and low uric acid levels with univariate- and multivariate analysis using a cause-specific Cox model. Twenty centers from 10 countries reported data on 366 allogeneic stem cell transplantation recipients. There were no significant differences in terms of baseline co-morbidity and disease stage between the high- and low uric acid group. Patients with uric acid levels above median measured before start of conditioning did not significantly differ from remaining in term of acute graft-versus-host disease grades II-IV incidence (HR=1.5, CI=1-2.4, p=0.08). However, they had significantly shorter overall survival (HR=2.8, CI=1.7-4.7, p<0.0001) and progression free survival (HR=1.6, CI=1.1-2.4, p=0.025). Non-relapse mortality was significantly increased in allogeneic stem cell transplantation recipients with high uric acid levels (HR=2.7, CI=1.4-5.0, p=0.003). Finally, the incidence of relapse after allogeneic stem cell transplantation was increased in patients with higher uric acid levels (HR=1.6, CI=1-2.5, p=0.04). We conclude that high uric acid levels before the start of conditioning correlate with increased mortality after allogeneic stem cell transplantation.

KEYWORDS:

Biomarker; Conditioning Regimen; Laboratory Hematology; Stem Cell Transplantation; Uric Acid

PMID:
31601686
DOI:
10.3324/haematol.2019.228668
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center