Donor Statin Treatment Protects Against Severe Acute Graft-Versus-Host Disease After Related Allogeneic Hematopoietic Cell Transplantation
Blood. 2009 Dec 4;[Epub Ahead of Print], M Rotta, BE Storer, RF Storb, PJ Martin, S Heimfeld, A Peffer, DG Maloney, HJ Deeg, BM Sandmaier, FR Appelbaum, M Mielcarek
ABSTRACT
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.
