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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.

Baron F, Labopin M, Ruggeri A, Mohty M, Sanz G, Milpied N, Bacigalupo A, Rambaldi A, Bonifazi F, Bosi A, Sierra J, Yakoub-Agha I, Santasusana JM, Gluckman E, Nagler A - J Hematol Oncol (2015)

Bottom Line: 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).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.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, University of Liège, CHU Sart-Tilman, 4000, Liège, Belgium. f.baron@ulg.ac.be.

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.

No MeSH data available.


Related in: MedlinePlus

Relapse incidence (a), NRM (b), LFS (c), and overall survival (d) in male patients given female URD (n = 131) versus in male patients given male UCB (n = 119)
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Fig3: Relapse incidence (a), NRM (b), LFS (c), and overall survival (d) in male patients given female URD (n = 131) versus in male patients given male UCB (n = 119)

Mentions: The 2-year incidence of relapse was similar in male patients given female UCB (29.2 %) and in other patients (26.2 %, P = 0.4) (Fig. 2). The figures were 22.8 % in male patients given male UCB (P = 0.35 in comparison to male patients given female UCB) (Fig. 3) and 26.3 % in female patients given female UCB (Table 2). In multivariate analyses including data from all patients, male patients given female UCB had a similar incidence of relapse than other gender combinations (HR = 1.4, 95 % CI 0.9–2.1; P = 0.13). Similar observations were made when the analyses were restricted to patients for whom data on TNC and HLA compatibility were available (HR = 1.2, 95 % CI 0.8–1.9; P = 0.4) (Table 3). Factors associated with increased relapse incidence in multivariate analysis included older recipient age (P = 0.03), CR2 or advanced disease (P < 0.001) versus CR1, reduced-intensity conditioning (RIC) (P = 0.04), and secondary AML (P < 0.001).Fig. 2


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.

Baron F, Labopin M, Ruggeri A, Mohty M, Sanz G, Milpied N, Bacigalupo A, Rambaldi A, Bonifazi F, Bosi A, Sierra J, Yakoub-Agha I, Santasusana JM, Gluckman E, Nagler A - J Hematol Oncol (2015)

Relapse incidence (a), NRM (b), LFS (c), and overall survival (d) in male patients given female URD (n = 131) versus in male patients given male UCB (n = 119)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4594748&req=5

Fig3: Relapse incidence (a), NRM (b), LFS (c), and overall survival (d) in male patients given female URD (n = 131) versus in male patients given male UCB (n = 119)
Mentions: The 2-year incidence of relapse was similar in male patients given female UCB (29.2 %) and in other patients (26.2 %, P = 0.4) (Fig. 2). The figures were 22.8 % in male patients given male UCB (P = 0.35 in comparison to male patients given female UCB) (Fig. 3) and 26.3 % in female patients given female UCB (Table 2). In multivariate analyses including data from all patients, male patients given female UCB had a similar incidence of relapse than other gender combinations (HR = 1.4, 95 % CI 0.9–2.1; P = 0.13). Similar observations were made when the analyses were restricted to patients for whom data on TNC and HLA compatibility were available (HR = 1.2, 95 % CI 0.8–1.9; P = 0.4) (Table 3). Factors associated with increased relapse incidence in multivariate analysis included older recipient age (P = 0.03), CR2 or advanced disease (P < 0.001) versus CR1, reduced-intensity conditioning (RIC) (P = 0.04), and secondary AML (P < 0.001).Fig. 2

Bottom Line: 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).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.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, University of Liège, CHU Sart-Tilman, 4000, Liège, Belgium. f.baron@ulg.ac.be.

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.

No MeSH data available.


Related in: MedlinePlus