Faculty Collaboration Database

Graft-versus-host disease in recipients of male unrelated donor compared with parous female sibling donor transplants. Blood Adv 2018 May 08;2(9):1022-1031

Date

05/10/2018

Pubmed ID

29739773

Pubmed Central ID

PMC5941995

DOI

10.1182/bloodadvances.2017013052

Scopus ID

2-s2.0-85060905082 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

Optimal donor selection is critical for successful allogeneic hematopoietic cell transplantation (HCT). Donor sex and parity are well-established risk factors for graft-versus-host disease (GVHD), with male donors typically associated with lower rates of GVHD. Well-matched unrelated donors (URDs) have also been associated with increased risks of GVHD as compared with matched sibling donors. These observations raise the question of whether male URDs would lead to more (or less) favorable transplant outcomes as compared with parous female sibling donors. We used the Center for International Blood and Marrow Transplant Research registry to complete a retrospective cohort study in adults with acute myeloid leukemia, acute lymphoblastic leukemia, or myelodysplastic syndrome, who underwent T-cell replete HCT from these 2 donor types (parous female sibling or male URD) between 2000 and 2012. Primary outcomes included grade 2 to 4 acute GVHD (aGVHD), chronic GVHD (cGVHD), and overall survival. Secondary outcomes included disease-free survival, transplant-related mortality, and relapse. In 2813 recipients, patients receiving male URD transplants (n = 1921) had 1.6 times higher risk of grade 2 to 4 aGVHD (P < .0001). For cGVHD, recipient sex was a significant factor, so donor/recipient pairs were evaluated. Female recipients of male URD grafts had a higher risk of cGVHD than those receiving parous female sibling grafts (relative risk [RR] = 1.43, P < .0001), whereas male recipients had similar rates of cGVHD regardless of donor type (RR = 1.09, P = .23). Donor type did not significantly affect any other end point. We conclude that when available, parous female siblings are preferred over male URDs.

Author List

Kumar AJ, Kim S, Hemmer MT, Arora M, Spellman SR, Pidala JA, Couriel DR, Alousi AM, Aljurf MD, Cahn JY, Cairo MS, Cutler CS, Farhan S, Gergis U, Hale GA, Hashmi SK, Inamoto Y, Kamble RT, Kharfan-Dabaja MA, MacMillan ML, Marks DI, Nakasone H, Norkin M, Qayed M, Ringden O, Schouten HC, Schultz KR, Solh MM, Teshima T, Urbano-Ispizua A, Verdonck LF, Gale RP, Hamilton BK, Majhail NS, Loren AW

Author

Soyoung Kim PhD Associate 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

Adult
Allografts
Disease-Free Survival
Donor Selection
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Myelodysplastic Syndromes
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Registries
Sex Factors
Siblings
Survival Rate
Unrelated Donors