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J Hematol Oncol. 2015 Oct 6;8:107. doi: 10.1186/s13045-015-0207-4.

Unrelated cord blood transplantation for adult patients with acute myeloid leukemia: higher incidence of acute graft-versus-host disease and lower survival in male patients transplanted with female unrelated cord blood--a report from Eurocord, the Acute Leukemia Working Party, and the Cord Blood Committee of the Cellular Therapy and Immunobiology Working Party of the European Group for Blood and Marrow Transplantation.

Author information

1
Department of Hematology, University of Liège, CHU Sart-Tilman, 4000, Liège, Belgium. f.baron@ulg.ac.be.
2
EBMT Paris Office, Hospital Saint Antoine, Paris, France. myriam.labopin@upmc.fr.
3
Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France. annalisa.ruggeri@sat.aphp.fr.
4
AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France. annalisa.ruggeri@sat.aphp.fr.
5
AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France. mohamad.mohty@inserm.fr.
6
Hospital Universitario La Fe - Servicio de Hematologia, Valencia, Spain. sanz_gui@gva.es.
7
CHU Bordeaux - Hôpital Haut-leveque, Pessac, France. noel.milpied@chu-bordeaux.fr.
8
Department of Haematology II, Ospedale San Martino, Genova, Italy. andrea.bacigalupo@hsanmartino.it.
9
Azienda Ospedaliera Papa Giovanni XXIII-Hematology and Bone Marrow Transplant Unit, Bergamo, Italy. arambaldi@hpg23.it.
10
Institute of Hematology and Medical, Oncology L and A Seràgnoli, S.Orsola-Malpighi Hospital, Bologna University, Bologna, Italy. francesca.bonifazi@unibo.it.
11
BMT Unit Department of Hematology, Ospedale di Careggi, Firenze, Italy. alberto.bosi@unifi.it.
12
Hematology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain. JSierra@santpau.cat.
13
Hôpital HURIEZ - UAM allo-CSH - CHRU, Lille, France. i-yakoub-agha@orange.fr.
14
ICO-Hospital Universitari Germans Trias i Pujol, Jose Carreras Research Institute, Barcelona, Spain. jribera@iconcologia.net.
15
Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco, Monaco, Monaco. eliane.gluckman@sls.aphp.fr.
16
EBMT Paris Office, Hospital Saint Antoine, Paris, France. Arnon.Nagler@sheba.health.gov.il.
17
Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel. Arnon.Nagler@sheba.health.gov.il.

Abstract

BACKGROUND:

In the setting of allogeneic human leukocyte antigen (HLA)-matched bone marrow transplantation, transplanting male patients with grafts from female donors has been associated with a higher incidence of graft-versus-host disease (GVHD) and of nonrelapse mortality (NRM). The aim of the current analysis was to compare transplantation outcomes in male patients given female unrelated cord blood (UCB) versus other gender combinations.

PATIENTS AND METHODS:

Data from 552 consecutive patients with acute myeloid leukemia (AML) given a single UCB transplantation between 2000 and 2014 were included.

RESULTS:

In comparison with other gender combination, male patients given female UCB (n = 131) had a trend for a higher incidence of grades II-IV acute GVHD (33 versus 25 %, P = 0.08), a trend for a higher incidence of NRM (41 versus 33 %, P = 0.06), and a lower leukemia-free (LFS, 30 versus 41 %, P = 0.01) and overall survival (OS, 33 versus 45 %, P = 0.008). In multivariate analyses, taking into consideration all patients for which data on HLA-matching and cell dose transplanted were fully available (n = 363), male patients transplanted with a female UCB had a trend for a higher incidence of grade III-IV acute GVHD (hazard ratio (HR) = 2.0, P = 0.06), a trend for a higher NRM (HR = 1.5, P = 0.06), and a worse LFS (HR = 1.4, P = 0.04) and OS (HR = 1.3, P = 0.06).

CONCLUSIONS:

Our data suggest that male patients transplanted with female UCB might have higher risk of acute GVHD and of NRM leading to worse LFS and OS. These results should be confirmed in other large cohorts of patients before used for determining the choice of an UCB unit.

PMID:
26445106
PMCID:
PMC4594748
DOI:
10.1186/s13045-015-0207-4
[Indexed for MEDLINE]
Free PMC Article
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