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Influence of donor/recipient sex matching on outcome of allogeneic hematopoietic stem cell transplantation for aplastic anemia

Stern, Martin; Passweg, Jakob R.; Locasciulli, Anna; Socie, Gerard; Schrezenmeier, Hubert; Békássy, Albert LU ; Fuehrer, Monica; Hows, Jill; Korthof, Elisabeth T. and McCann, Shaun, et al. (2006) In Transplantation 82(2). p.218-226
Abstract
Background. Increased risk of transplant related mortality in male recipients of female hematopoietic stem cell grafts and in vitro reactivity of lymphocytes against H-Y encoded gene products in females with rejected male grafts have been documented. An increased rejection of male grafts in female recipients is not reported for solid organ or stem cell transplants and the role of H-Y as transplantation antigen has been controversial. Methods. Data from 1481 patients with a hematopoietic stem cell transplant for aplastic anemia reported from 154 centers in 28 countries were analyzed. Outcome was compared between patients with donors of the same or opposite Sex. Results. Survival at 5 years was significantly better in patients with donors... (More)
Background. Increased risk of transplant related mortality in male recipients of female hematopoietic stem cell grafts and in vitro reactivity of lymphocytes against H-Y encoded gene products in females with rejected male grafts have been documented. An increased rejection of male grafts in female recipients is not reported for solid organ or stem cell transplants and the role of H-Y as transplantation antigen has been controversial. Methods. Data from 1481 patients with a hematopoietic stem cell transplant for aplastic anemia reported from 154 centers in 28 countries were analyzed. Outcome was compared between patients with donors of the same or opposite Sex. Results. Survival at 5 years was significantly better in patients with donors from the same sex: 68% vs. 60% (P=0.001). Male patients with female donors had a decreased survival (relative risk of death 1.52, P < 0.001) and an increased risk of severe graft-versus-host disease (relative risk 1.33, P=0.03) compared to recipients of sex-matched grafts. Female patients with male donors had a decreased survival (relative risk of death 1.44, P=0.01) and an increased risk of rejection (relative risk 2.20, P=0.01) compared to recipients of sex-matched grafts. In a subgroup analysis, the negative effects of donor/recipient sex-mismatching appeared confined to patients receiving conditioning regimens not containing antithymocyte globulin. Conclusions. These data confirm H-Y as a clinically relevant transplantation antigen, in both the graft-versus-host and the host-versus-graft direction. Wherever possible, donor-recipient sex-matching should be integrated into donor selection algorithms. (Less)
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published
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keywords
graft-versus-host disease, histocompatibility antigens, minor, severe aplastic anemia, hematopoietic stem cell transplantation, graft rejection
in
Transplantation
volume
82
issue
2
pages
218 - 226
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000239441600014
  • pmid:16858285
  • scopus:33746390423
ISSN
1534-6080
DOI
10.1097/01.tp.0000226156.99206.d1
language
English
LU publication?
yes
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b481f478-58c7-4c59-b176-1ad2b69cb781 (old id 398607)
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http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=16858285&cmd=showdetailview&indexed=google
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2007-10-19 13:38:03
date last changed
2019-07-16 02:30:50
@article{b481f478-58c7-4c59-b176-1ad2b69cb781,
  abstract     = {Background. Increased risk of transplant related mortality in male recipients of female hematopoietic stem cell grafts and in vitro reactivity of lymphocytes against H-Y encoded gene products in females with rejected male grafts have been documented. An increased rejection of male grafts in female recipients is not reported for solid organ or stem cell transplants and the role of H-Y as transplantation antigen has been controversial. Methods. Data from 1481 patients with a hematopoietic stem cell transplant for aplastic anemia reported from 154 centers in 28 countries were analyzed. Outcome was compared between patients with donors of the same or opposite Sex. Results. Survival at 5 years was significantly better in patients with donors from the same sex: 68% vs. 60% (P=0.001). Male patients with female donors had a decreased survival (relative risk of death 1.52, P &lt; 0.001) and an increased risk of severe graft-versus-host disease (relative risk 1.33, P=0.03) compared to recipients of sex-matched grafts. Female patients with male donors had a decreased survival (relative risk of death 1.44, P=0.01) and an increased risk of rejection (relative risk 2.20, P=0.01) compared to recipients of sex-matched grafts. In a subgroup analysis, the negative effects of donor/recipient sex-mismatching appeared confined to patients receiving conditioning regimens not containing antithymocyte globulin. Conclusions. These data confirm H-Y as a clinically relevant transplantation antigen, in both the graft-versus-host and the host-versus-graft direction. Wherever possible, donor-recipient sex-matching should be integrated into donor selection algorithms.},
  author       = {Stern, Martin and Passweg, Jakob R. and Locasciulli, Anna and Socie, Gerard and Schrezenmeier, Hubert and Békássy, Albert and Fuehrer, Monica and Hows, Jill and Korthof, Elisabeth T. and McCann, Shaun and Tichelli, Andre and Zoumbos, Nicholas C. and Marsh, Judith C. W. and Bacigalupo, Andrea and Gratwohl, Alois},
  issn         = {1534-6080},
  keyword      = {graft-versus-host disease,histocompatibility antigens,minor,severe aplastic anemia,hematopoietic stem cell transplantation,graft rejection},
  language     = {eng},
  number       = {2},
  pages        = {218--226},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Transplantation},
  title        = {Influence of donor/recipient sex matching on outcome of allogeneic hematopoietic stem cell transplantation for aplastic anemia},
  url          = {http://dx.doi.org/10.1097/01.tp.0000226156.99206.d1},
  volume       = {82},
  year         = {2006},
}