New autoimmune diseases after cord blood transplantation: A retrospective study of EUROCORD and the autoimmune disease working party of the European group for blood and marrow transplantation

Thomas Daikeler, Myriam Labopin, Annalisa Ruggeri, Alessandro Crotta, Mario Abinun, Ayad Ahmed Hussein, Kristina Carlson, Jérôme Cornillon, Jose L. Diez-Martin, Virginie Gandemer, Maura Faraci, Caroline Lindemans, Anne O'Meara, Valerie Mialou, Marleen Renard, Petr Sedlacek, Anne Sirvent, Gérard Socié, Federica Sora, Stefania VarottoJaime Sanz, Jan Voswinkel, Ajay Vora, M. Akif Yesilipek, Andree Laure Herr, Eliane Gluckman, Dominique Farge, Vanderson Rocha

Research output: Contribution to journalArticlepeer-review

Abstract

To describe the incidence, risk factors, and treatment of autoimmune diseases (ADs) occurring after cord blood transplantation (CBT), we analyzed both CBT recipients reported to EUROCORD who had developed at least 1 new AD and those who had not. Fifty-two of 726 reported patients developed at least 1 AD within 212 days (range, 27-4267) after CBT. Cumulative incidence of ADs after CBT was 5.0% ± 1% at 1 year and 6.6% ± 1% at 5 years. Patients developing ADs were younger and had more nonmalignant diseases (P <.001). ADs target hematopoietic (autoimmune hemolytic anemia, n = 20; Evans syndrome, n = 9; autoimmune thrombocytopenia, n = 11; and immune neutropenia, n = 1) and other tissues (thyroiditis, n = 3; psoriasis, n = 2; Graves disease, n = 1; membranous glomerulonephritis, n = 2; rheumatoid arthritis, n = 1; ulcerative colitis, n = 1; and systemic lupus erythematosus, n = 1). Four patients developed 2 ADs (3 cases of immune thrombocytopenia followed by autoimmune hemolytic anemia and 1 Evans syndrome with rheumatoid arthritis). By multivariate analysis, the main risk factor for developing an AD was nonmalignant disease as an indication for CBT (P = .0001). Hematologic ADs were most often treated with steroids, rituximab, and cyclosporine. With a median follow-up of 26 months (range, 2-91), 6 of 52 patients died as a consequence of ADs. We conclude that CBT may be followed by potentially life-threatening, mainly hematologic ADs.

Original languageEnglish
Pages (from-to)1059-1064
Number of pages6
JournalBlood
Volume121
Issue number6
DOIs
Publication statusPublished - Feb 7 2013

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

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