Authors:
Marcello Rotta, Barry E. Storer, Rainer F. Storb, Paul J. Martin, Shelly Heimfeld, Amanda Peffer, David G. Maloney, H. Joachim Deeg, Brenda M. Sandmaier, Frederick R. Appelbaum and Marco Mielcarek
Summary:
We retrospectively analyzed outcomes among 567 patients with hematologic malignancies who had hematopoietic cell transplantation from HLA-identical sibling donors at a single institution between 2001 and 2007 for a correlation between statin use and risk of graft-versus-host disease (GVHD). Compared to allografts where neither the donor nor recipient was treated with a statin at the time of transplant (n=464), statin use by the donor and not the recipient (n=75) was associated with a decreased risk of grade 3-4 acute GVHD (multivariate hazard ratio [HR], 0.28; 95% confidence interval [CI], 0.1-0.9). Statin use by both donor and recipient (n=12) was suggestively associated with a decreased risk of grade 3-4 acute GVHD (HR, 0.00; 95% CI, undefined), while statin use by the recipient and not the donor (n=16) did not confer GVHD protection. Risks of chronic GVHD, recurrent malignancy, non-relapse mortality and overall mortality were not significantly affected by donor or recipient statin exposure. Statin-associated GVHD protection was restricted to recipients with cyclosporine-based postgrafting immunosuppression and was not observed among those given tacrolimus (p=0.009). These results suggest that donor statin treatment may be a promising strategy to prevent severe acute GVHD without compromising immunologic control of the underlying malignancy.
Source:
Blood; (12/04/09)