Evidence map›Paper›PMID 40397195›Full record

ArticleAnnals of hematology2025

Impact of graft-versus-host disease on outcomes of cord blood transplantation according to HLA disparity and its prophylaxis type.

Hisayuki Yokoyama, Shigeo Fuji, Makoto Murata, Masahiro Hirayama, Atsushi Wake, Naoyuki Uchida, Masatsugu Tanaka, Makoto Onizuka, Satoshi Takahashi, Noriko Doki and 13 more

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In one paragraph

Article in Annals of hematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Hisayuki YokoyamaDivision of Hematology and Cell Therapy, Yamagata University Graduate School of Medicine, Yamagata, Japan. yokoyamah@med.id.yamagata-u.ac.jp.
Shigeo FujiDepartment of Hematology, Osaka International Cancer Institute, Osaka, Japan.
Makoto MurataDepartment of Hematology, Shiga University of Medical Science, Otsu, Japan.
Masahiro HirayamaDepartment of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan.
Atsushi WakeDepartment of Hematology, Toranomon Hospital, Kajigaya, Japan.
Naoyuki UchidaDepartment of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan.
Masatsugu TanakaDepartment of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
Makoto OnizukaDepartment of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan.
Satoshi TakahashiDepartment of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Noriko DokiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Yumiko MaruyamaDepartment of Hematology, University of Tsukuba Hospital, Tsukuba, Japan.
Kazuya IshiwataDepartment of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Kajigaya, Japan.
Yasufumi UeharaDepartment of Hematology, Kitakyushu City Hospital Organization, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
Tetsuya NishidaDepartment of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan.
Masashi SawaDepartment of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan.
Toshiro KawakitaDepartment of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan.
Tetsuya EtoDepartment of Hematology, Hamanomachi Hospital, Fukuoka, Japan.
Fumihiko IshimaruJapanese Red Cross Kanto-Koshinetsu Block Blood Center, Atsugi, Japan.
Koji KatoCentral Japan Cord Blood Bank, Seto, Japan.
Tatsuo IchinoheDepartment of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
Yoshiko AtsutaJapanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
Seitaro TerakuraDepartment of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Satoko MorishimaDivision of Endocrinology, Diabetes and Metabolism, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Hematology, RheumatologyNishihara, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study evaluated the impact of acute graft-versus-host disease (aGVHD) on cord blood transplantation (CBT) outcomes based on human leukocyte antigen (HLA) disparity and GVHD prophylaxis type. Data from 4,196 adult patients with acute myeloid leukemia, acute lymphoblastic leukemia, or myelodysplastic syndrome were analyzed. Patients were classified by HLA mismatch (8/8-6/8, 5/8, and 4/8-2/8) and further by GVHD prophylaxis type (methotrexate [MTX] or mycophenolate mofetil [MMF]). The impact of aGVHD was assessed using a time-dependent Cox model. Grade I-II aGVHD improved overall survival (OS) in all groups, regardless of HLA mismatches or prophylaxis type. However, grade III-IV aGVHD worsened OS across MMF groups, while in MTX groups, it was unfavorable only in the HLA 8/8-6/8-matched group (HR 1.6, P = 0.01). Grade III-IV aGVHD increased non-relapse mortality (NRM) across all groups but was more pronounced in HLA 4/8-2/8-matched patients receiving MMF. Notably, relapse risk decreased in HLA 4/8-2/8-matched patients with MTX prophylaxis, partially offsetting the negative impact of grade III-IV aGVHD on NRM. These findings suggest that the impact of aGVHD varies with HLA mismatches and prophylaxis type. MTX prophylaxis may mitigate the adverse effects of severe aGVHD in highly mismatched cases, unlike MMF prophylaxis. Careful donor selection considering HLA mismatches is essential when using MMF prophylaxis to manage severe aGVHD and reduce NRM risk.

Indexed as

Cord Blood Stem Cell TransplantationGraft vs Host DiseaseHLA AntigensAdolescentAdultAgedFemaleHistocompatibility TestingHumansLeukemia, Myeloid, AcuteMaleMethotrexateMiddle AgedMycophenolic AcidMyelodysplastic SyndromesPrecursor Cell Lymphoblastic Leukemia-LymphomaHLA AntigensMethotrexateMycophenolic AcidAcute graft-versus-host diseaseCord blood transplantationGVHD prophylaxisHLA matching

Identifiers

PMID40397195
PMCPMC12141169

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.