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

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...

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Detalles Bibliográficos
Autores: Penack, Olaf|||0000-0003-4876-802X, Peczynski, Christophe, van der Werf, Steffie, Finke, Jürgen, Ganser, Arnold, Schoemans, Helene|||0000-0002-7568-8239, Pavlu, Jiri|||0000-0001-5219-5637, Niittyvuopio, Riitta, Schroyens, Wilfried, Kaynar, Leylagül, Blau, Igor-Wolfgang, van der Velden, Walter, Sierra, Jorge|||0000-0002-7966-0356, Cortelezzi, Agostino, Wulf, Gerald, Turlure, Pascal, Rovira Argelagués, Montserrat|||0000-0001-7786-9079, Ozkurt, Zubeyde Nur, Pascual Cascón, María Jesús, Moreira, Maria C., Clausen, Johannes, Greinix, Hildegard, Duarte, Rafael F., Basak, Grzegorz|||0000-0003-3858-8180
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:284166
Acceso en línea:https://ddd.uab.cat/record/284166
https://dx.doi.org/urn:doi:10.3324/haematol.2019.228668
Access Level:acceso abierto
Palabra clave:Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Prospective Studies
Retrospective Studies
Transplantation Conditioning
Transplantation, Homologous
Uric Acid
Descripción
Sumario: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.

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