Donor and recipient sex in allogeneic stem cell transplantation: what really matters. Haematologica 2016 Oct;101(10):1260-1266
Date
06/30/2016Pubmed ID
27354023Pubmed Central ID
PMC5046656DOI
10.3324/haematol.2016.147645Scopus ID
2-s2.0-84989332191 (requires institutional sign-in at Scopus site) 51 CitationsAbstract
We investigated whether and how recipient-donor sex affects transplantation outcomes of 11,797 patients transplanted between 2008 and 2010. Thirty-seven percent were male recipients with male donors, 21% male recipients with female donors, 25% female recipients with male donors, and 17% female recipients with female donors. In multivariable analyses, male recipients had inferior overall survival and progression-free survival compared to females regardless of donor sex, with an 11% relative increase in the hazard of death (P<0.0001) and a 10% relative increase in the hazard of death or relapse (P<0.0001). The detrimental effect of male recipients varied by donor sex. For male recipients with male donors, there was a 12% relative increase in the subdistribution hazard of relapse compared with female recipients with male donors (P=0.0036) and male recipients with female donors (P=0.0037). For male recipients with female donors, there was a 19% relative increase in the subdistribution hazard of non-relapse mortality compared with male recipients with male donors (P<0.0001) and a 22% relative increase compared with female recipients with male donors (P=0.0003). In addition, male recipients with female donors showed a 21% relative increase in the subdistribution hazard of chronic graft-versus-host disease (P<0.0001) compared with female recipients with male donors. Donor sex had no effect on outcomes for female recipients. Transplantation of grafts from male and female donors was associated with inferior overall survival and progression-free survival in male recipients with differing patterns of failure. Recipient sex is an important prognostic factor independent of donor sex.
Author List
Kim HT, Zhang MJ, Woolfrey AE, St Martin A, Chen J, Saber W, Perales MA, Armand P, Eapen MAuthors
Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of WisconsinWael Saber MD, MS Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Disease-Free Survival
Female
Graft vs Host Disease
Humans
Male
Middle Aged
Recurrence
Sex Factors
Stem Cell Transplantation
Survival Analysis
Transplantation, Homologous
Young Adult
