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Who is the best hematopoietic stem-cell donor for a male patient with acute leukemia?
Transplantation. 2014 Sep 15; 98(5):569-77.T

Abstract

BACKGROUND

Female donors for male recipients worsen the outcome of allogeneic hematopoietic stem-cell transplantation. We wanted to find out whether a male human leukocyte antigen (HLA)-matched unrelated donor (MUD, 8/8, n=2,014) might be an alternative to a female HLA-identical sibling donor (n=2,656) for male patients with acute leukemia.

METHODS

This is a retrospective analysis from the Acute Leukaemia Working Party of the European Group for Blood and Marrow Transplantation.

RESULTS

The relative risk (RR) of acute graft-versus-host disease (GVHD) of grades II to IV was increased in the MUD group with acute myeloid leukemia (AML) (RR, 1.47; P<0.001) and acute lymphoblastic leukemia (ALL) (RR, 1.76; P<0.001). There was no difference in incidence of chronic GVHD and nonrelapse mortality between the two groups. Probability of relapse was lower in the MUD group than in the sibling group in patients with ALL (hazards ratio [HR], 0.75; P=0.04) but not in the AML patients (HR, 0.89; P=0.17). Survival was not different between the groups. Leukemia-free survival (LFS) was also similar in the sibling and MUD groups in patients with AML (HR, 1.01; P=0.81) or ALL (HR, 0.93; P=0.45). Factors significantly associated with reduced LFS included active disease, poor cytogenetics, age, year of hematopoietic stem-cell transplantation, reduced-intensity conditioning, and the use of antithymocyte globulin.

CONCLUSION

Male patients who received grafts from male MUDs demonstrated an increased incidence of acute GVHD and LFS same as when using HLA-identical female donors.

Authors+Show Affiliations

1 Center for Allogeneic Stem Cell Transplantation and Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden. 2 Department of Haematology, Hôpital Saint Antoine, Paris, France. 3 Department of Bone Marrow Transplantation, Essen, University Hospital, Essen, Germany. 4 Medizinische Klinik m. S. Hämatologie/Onkologie, Charité Universitätsmedizin, Berlin, Germany. 5 Medizinische Klinik und Poliklinik I, Universitätsklinikum Dresden, Dresden, Germany. 6 CHU Bordeaux, Hôpital Haut-leveque, Pessac, France. 7 Division of Hematology, Oncology and Hemostasiology, University Hospital Leipzig, Leipzig, Germany. 8 Service Hématologie Greffe de Moelle, Centre Pierre et Marie Curie, Alger, Algeria. 9 Department of Hematology and BMT, Silesian Medical Academy, Katowice, Poland. 10 Department of Hematology/Oncology, Hannover Medical University, Hannover, Germany. 11 Department of Hematology - BMT, Hôpital St. Louis, Paris, France. 12 Department of Hematology/Oncology, University of Münster, Münster, Germany. 13 Division of Hematology, Helsinki University Central Hospital, Helsinki, Finland. 14 Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, United Kingdom. 15 Address correspondence to: Olle Ringdén, M.D., Ph.D., Karolinska Institutet, Division of Therapeutic Immunology, Karolinska University Hospital Huddinge, F79, SE-141 86 Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24798307

Citation

Ringdén, Olle, et al. "Who Is the Best Hematopoietic Stem-cell Donor for a Male Patient With Acute Leukemia?" Transplantation, vol. 98, no. 5, 2014, pp. 569-77.
Ringdén O, Labopin M, Solders M, et al. Who is the best hematopoietic stem-cell donor for a male patient with acute leukemia? Transplantation. 2014;98(5):569-77.
Ringdén, O., Labopin, M., Solders, M., Beelen, D., Arnold, R., Ehninger, G., Milpied, N., Niederwieser, D., Hamladji, R. M., Kyrcz-Krzemien, S., Ganser, A., Socié, G., Stelljes, M., Volin, L., Craddock, C., & Mohty, M. (2014). Who is the best hematopoietic stem-cell donor for a male patient with acute leukemia? Transplantation, 98(5), 569-77. https://doi.org/10.1097/TP.0000000000000102
Ringdén O, et al. Who Is the Best Hematopoietic Stem-cell Donor for a Male Patient With Acute Leukemia. Transplantation. 2014 Sep 15;98(5):569-77. PubMed PMID: 24798307.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Who is the best hematopoietic stem-cell donor for a male patient with acute leukemia? AU - Ringdén,Olle, AU - Labopin,Myriam, AU - Solders,Martin, AU - Beelen,Dietrich, AU - Arnold,Renate, AU - Ehninger,Gerhard, AU - Milpied,Noel, AU - Niederwieser,Dietger, AU - Hamladji,Rose-Marie, AU - Kyrcz-Krzemien,Slawomira, AU - Ganser,Arnold, AU - Socié,Gerard, AU - Stelljes,Matthias, AU - Volin,Liisa, AU - Craddock,Charles, AU - Mohty,Mohamad, AU - ,, PY - 2014/5/7/entrez PY - 2014/5/7/pubmed PY - 2014/12/19/medline SP - 569 EP - 77 JF - Transplantation JO - Transplantation VL - 98 IS - 5 N2 - BACKGROUND: Female donors for male recipients worsen the outcome of allogeneic hematopoietic stem-cell transplantation. We wanted to find out whether a male human leukocyte antigen (HLA)-matched unrelated donor (MUD, 8/8, n=2,014) might be an alternative to a female HLA-identical sibling donor (n=2,656) for male patients with acute leukemia. METHODS: This is a retrospective analysis from the Acute Leukaemia Working Party of the European Group for Blood and Marrow Transplantation. RESULTS: The relative risk (RR) of acute graft-versus-host disease (GVHD) of grades II to IV was increased in the MUD group with acute myeloid leukemia (AML) (RR, 1.47; P<0.001) and acute lymphoblastic leukemia (ALL) (RR, 1.76; P<0.001). There was no difference in incidence of chronic GVHD and nonrelapse mortality between the two groups. Probability of relapse was lower in the MUD group than in the sibling group in patients with ALL (hazards ratio [HR], 0.75; P=0.04) but not in the AML patients (HR, 0.89; P=0.17). Survival was not different between the groups. Leukemia-free survival (LFS) was also similar in the sibling and MUD groups in patients with AML (HR, 1.01; P=0.81) or ALL (HR, 0.93; P=0.45). Factors significantly associated with reduced LFS included active disease, poor cytogenetics, age, year of hematopoietic stem-cell transplantation, reduced-intensity conditioning, and the use of antithymocyte globulin. CONCLUSION: Male patients who received grafts from male MUDs demonstrated an increased incidence of acute GVHD and LFS same as when using HLA-identical female donors. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/24798307/Who_is_the_best_hematopoietic_stem_cell_donor_for_a_male_patient_with_acute_leukemia L2 - https://doi.org/10.1097/TP.0000000000000102 DB - PRIME DP - Unbound Medicine ER -