Association of uric acid levels before start of conditioning with mortality after allogeneic hematopoietic stem cell transplantation - a prospective, non-interventional study of the EBMT Transplant Complication Working Party
Penack, Olaf (Charité - Universitätsmedizin Berlin)
Peczynski, Christophe (EBMT Statistical Unit)
van der Werf, Steffie (EBMT Data Office)
Finke, Jürgen (University of Freiburg)
Ganser, Arnold (Hannover Medical School)
Schoemans, Helene (University Hospitals Leuven (Bèlgica))
Pavlu, Jiri (Imperial College London)
Niittyvuopio, Riitta. (HUCH Comprehensive Cancer Center)
Schroyens, Wilfried (University Hospital Antwerp (Bèlgica))
Kaynar, Leylagül (Erciyes University Medical Faculty)
Blau, Igor W. (Charité - Universitätsmedizin Berlin)
van der Velden, Walter (Radboud University - Nijmegen Medical Centre)
Sierra, Jorge (Institut d'Investigació Biomèdica Sant Pau)
Cortelezzi, Agostino (Fondazione IRCCS - Ca'Granda)
Wulf, Gerald (Universitätsklinikum Göttingen)
Turlure, Pascal (CHRU Limoges)
Rovira, Montserrat (Hospital Clínic i Provincial de Barcelona)
Ozkurt, Zubeydenur (Gazi University)
Pascual-Cascon, Maria J. (Hospital Regional Universitario de Málaga)
Moreira, Maria C. (Instituto National do Cancer)
Clausen, Johannes (Ordensklinikum Linz Elisabethinen)
Greinix, Hildegard (LKH - University Hospital Graz)
Duarte, Rafael F. (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Basak, Grzegorz (Medical University of Warsaw)
Universitat Autònoma de Barcelona

Data:	2020
Resum:	ric acid is a danger signal contributing to inflammation. Its relevance to allogeneic stem cell transplantation (alloSCT) derives from preclinical models where the depletion of uric acid led to improved survival and reduced graft-versus-host disease (GvHD). In a clinical pilot trial, peritransplant uric acid depletion reduced acute GvHD incidence. This prospective international multicenter study aimed to investigate the association of uric acid serum levels before start of conditioning with alloSCT outcome. We included patients with acute leukemia, lymphoma or myelodysplastic syndrome receiving a first matched sibling alloSCT 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 alloSCT 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 the remaining in terms of acute GvHD grades II-IV incidence (Hazard ratio [HR] 1. 5, 95% Confidence interval [CI]: 1. 0-2. 4, P=0. 08). However, they had significantly shorter overall survival (HR 2. 8, 95% CI: 1. 7-4. 7, P<0. 0001) and progression free survival (HR 1. 6, 95% CI: 1. 1-2. 4, P=0. 025). Non-relapse mortality was significantly increased in alloSCT recipients with high uric acid levels (HR 2. 7, 95% CI: 1. 4-5. 0, P=0. 003). Finally, the incidence of relapse after alloSCT was increased in patients with higher uric acid levels (HR 1. 6, 95% CI: 1. 0-2. 5, P=0. 04). We conclude that high uric acid levels before the start of conditioning correlate with increased mortality after alloSCT.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Prospective Studies ; Retrospective Studies ; Transplantation Conditioning ; Transplantation, Homologous ; Uric Acid
Publicat a:	Haematologica, Vol. 105 Núm. 7 (january 2020) , p. 1977-1983, ISSN 1592-8721

DOI: 10.3324/haematol.2019.228668
PMID: 31601686

7 p, 473.0 KB

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