Potential protective effect of Helicobacter pylori on the development of gastrointestinal GvHD

• Published in: Bone marrow transplantation (Basingstoke) Vol. 51; no. 6; pp. 819 - 824
• Main Authors: Velasco-Guardado, A, Mora-Soler, A, López-Corral, L, López-Godino, O, Vázquez-López, L, Blanco-Muñez, O, Pérez-López, E, Rodríguez-Pérez, A, Caballero-Barrigón, D
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-06-2016; Nature Publishing Group
• Subjects: 692/499; 692/699/1541; Adult; Bone marrow; Cell Biology; Complications and side effects; Confidence intervals; Female; Gastrointestinal diseases; Gastrointestinal Diseases - etiology; Gastrointestinal Diseases - microbiology; Graft vs Host Disease - diagnosis; Graft vs. host disease; Graft-versus-host reaction; Hazards; Health aspects; Health hazards; Helicobacter pylori; Helicobacter pylori - immunology; Hematology; Hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - mortality; Humans; Immune response; Immunosuppressive Agents - therapeutic use; Infections; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; original-article; Peripheral blood; Prevention; Prophylaxis; Prospective Studies; Public Health; Rapamycin; Regression analysis; Sirolimus - therapeutic use; Statistical analysis; Stem cell transplantation; Stem Cells; Survival Rate; Tacrolimus; Tacrolimus - therapeutic use; Transplantation; Transplantation Conditioning - methods; Transplants & implants; Urea
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2016.31

Previous reports ascribe a modulating capacity of the immune response to
Helicobacter pylori
(HP). Our hypothesis was to demonstrate in a prospective study that HP infection could have a protective effect against development of gastrointestinal GvHD in patients receiving allogeneic hematopoietic cell transplantation (HCT). Presence of HP before transplant was determined using C
13
urea breath test. Seventy-nine patients receiving an allogeneic HCT were included and 93.7% of them received PBSC; in 51.9%, the donor was unrelated. Acute gastrointestinal GvHD was diagnosed in 51.9% (
n
=41). In the multivariable analysis, HP infection was associated with a lower frequency of gastrointestinal GvHD (odds ratio (OR)=0.19 (95% confidence interval (CI): 0.05–0.67); in contrast, an unrelated donor was associated with a higher frequency of gastrointestinal GvHD (odds ratio=5.4 (95% confidence interval: 1.6–18.2). One year overall survival (OS) was 74%. In the multivariate Cox proportional-hazards regression analysis, stages 0–II gastrointestinal GvHD (hazards ratio (HR)=0.19), reduced intensity conditioning (HR=0.04) and tacrolimus-sirolimus GvHD prophylaxis (HR=0.06) were all associated with a better OS. In summary, HP infection could have a role in decreasing gastrointestinal GvHD in patients receiving allogeneic HCT from peripheral blood including related and unrelated donors.