Statin Treatment May Decrease Risk of Chronic GVHD after Allogeneic HCT, but Increase Risk of Recurrent Malignancy

Strategic Insights -

Researchers at the University of Washington, Fred Hutchinson Cancer Research Center, have investigated the impact of recipient statin treatment on graft-versus-host disease after allogeneic hematopoietic cell transplantation. The study, published in the journal Biology of Blood and Marrow Transplantation, analyzed outcomes among 1206 patients with hematologic malignancies who underwent hematopoietic cell transplantation between 2001 and 2007. The researchers found that recipient statin use at the time of transplant was associated with a decreased risk of extensive chronic GVHD among recipients with cyclosporine-based postgrafting immunosuppression, but an increased risk of recurrent malignancy.

Key Takeaways:

  • The study analyzed outcomes among 1206 patients with hematologic malignancies who underwent hematopoietic cell transplantation at a single institution between 2001 and 2007.
  • Recipient statin use at the time of transplant was associated with a decreased risk of extensive chronic GVHD among recipients with cyclosporine-based postgrafting immunosuppression.
  • The risk of recurrent malignancy was increased among recipients given cyclosporine-based immunosuppression who used statins at the time of transplant.
  • Recipient statin use had no apparent impact on the risks of cGVHD and recurrent malignancy among recipients given tacrolimus-based immunosuppression.
  • Risks of acute GVHD, nonrelapse mortality, and overall mortality were not significantly affected by recipient statin use.
  • The study suggests that recipient statin treatment at the time of allogeneic HCT may decrease the risk of cGVHD in patients with cyclosporine-based immunosuppression, but at the expense of a compromised graft-versus-tumor effect.
  • M. Rotta and colleagues published their study in Biology of Blood and Marrow Transplantation (Impact of recipient statin treatment on graft-versus-host disease after allogeneic hematopoietic cell transplantation. Biology of Blood and Marrow Transplantation, 2010;16(10):1463-6).

Statistics:

  • 1206 patients with hematologic malignancies were analyzed in the study.
  • 630 patients underwent transplantation from HLA-identical siblings.
  • 576 patients underwent transplantation from HLA-matched unrelated donors.
  • 821 recipients were given cyclosporine-based postgrafting immunosuppression.
  • 385 recipients were given tacrolimus-based postgrafting immunosuppression.
  • 6% of recipients were given statins at the time of transplant.
  • 8% of recipients given tacrolimus-based immunosuppression were given statins.
  • The multivariate hazard ratio for extensive chronic GVHD among recipients with cyclosporine-based immunosuppression who used statins was 0.62 (95% CI, 0.4-1.0; p=.05).
  • The multivariate hazard ratio for recurrent malignancy among recipients with cyclosporine-based immunosuppression who used statins was 1.75 (95% CI, 1.0-3.0; p=.04).

Sources:

  • Rotta, M., et al. (2010). Impact of recipient statin treatment on graft-versus-host disease after allogeneic hematopoietic cell transplantation. Biology of Blood and Marrow Transplantation, 16(10), 1463-6.
  • This article was prepared by Biotech Week editors from staff and other reports.