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Cord blood transplantation may cause fatal autoimmune disease
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More than 5% of patients who underwent cord blood transplantation developed an autoimmune disease, according to study results.
Researchers conducted the study to determine incidence, risk factors and treatment of autoimmune diseases after patients had undergone cord blood transplantation. The investigators evaluated data on 726 transplantation recipients that had been reported to EUROCORD.
At least one autoimmune disease was observed in 52 of the patients within 212 days (range: 27 to 4,267 days) of cord blood transplantation.
The 1-year cumulative incidence of an autoimmune disease was 5 ± 1%. The incidence rate had increased to 6.6 ± 1% by 5 years.
Younger patients and those with non-malignant diseases were more likely to develop diseases (P<.001).
Autoimmune hemolytic anemia occurred in 20 patients, Evans syndrome occurred in nine patients, 11 patients developed autoimmune thrombocytopenia and one patient developed immune neutropenia. For diseases in other tissues, there were three cases of thyroiditis, two cases each of psoriasis and membranous glomerulonephritis, and one case each of Graves’ disease, rheumatoid arthritis, ulcerative colitis and systemic lupus erythematosus.
Two autoimmune diseases occurred in four patients. Three of those patients developed autoimmune thrombocytopenia followed by autoimmune hemolytic anemia, and one developed Evans syndrome with rheumatoid arthritis.
Multivariate analysis results indicated that non-malignant disease as indication for cord blood transplantation was the main risk factor for developing an autoimmune disease.
Steroids, rituximab (Rituxan, Genentech) and cyclosporine were the drugs most frequently used to treat hematological diseases.
At a median follow-up of 26 months (range, 2 to 91 months), six of the 52 patients who developed autoimmune diseases died as a consequence of those diseases.
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