Entrar/Registro  
HOME SPANISH
 
Revista de Hematología
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Revista de Hematología >Year 2011, Issue 1


Gutiérrez ACH, Borjas AOD, Cantú ROG, González LO, Jaime PJC, Gómez AD
Significance of sex disparity between donor and recipient in allogeneic stem cell transplantation using a reduced-intensity conditioning
Rev Hematol Mex 2011; 12 (1)

Language: Español
References: 20
Page: 17-22
PDF: 91.33 Kb.


Full text




ABSTRACT

Background: Allogeneic hematopoietic stem cell transplantation (HSCT) from a compatible HLA donor is the procedure of choice for the treatment of diverse neoplasic and non-neoplasic hematologic diseases. Some studies have found a higher incidence of graft versus host disease (GVHD) and rejection when there is sex disparity between donor and recipient. In this study we analyzed the incidence of GVHD and survival of patients receiving a reduced-intensity HSCT from donors with or without sex disparity.
Materials and Methods: We included 56 patients who underwent reduced intensity conditioning before allogeneic HSCT regardless of the underlying disease. Twenty nine patients were sex-matched with the donors and in 27 patients sex disparity between donor and recipient existed. The median follow-up was 34 months. Each patient received a reduced intensity conditioning with cyclophosphamide, busulfan and fludarabine; prophylaxis for GVHD included cyclosporine and methotrexate.
Results: The median dose of CD34+ infused was of 5.9 (±2.3) x 106 per kg of weight. Survival was higher in the group of patients with a donor of different sex (88% vs 79%), although without statistic significance (p=.209). The incidence of acute and chronic GVHD in the group of patients with same-sex donor was 31% and 17.2% respectively, while in the group of different sex it was 26% and 33.2% respectively, with no statistic significance. (p=.42 and p=.09 respectively). Complete chimerism was 58% in the no sex disparity group, significantly higher than 18.5% in the sex mistmached group (p=.004).
Conclusion: Sex disparity between donor and recipient had no influence in the incidence of GVHD and had not a measurable effect on survival. Ideally, a donor on the same sex as the receptor, if reduced intensity allogeneic hematopoietic stem cell transplantation is used, should be choose since there is a higher chance of achieve a complete chimerism.


Key words: Donor, recipient, allogeneic stem cell, transplantation, reduced-intensity conditioning.


REFERENCIAS

  1. Pai SY, Notarangelo LD. Hematopoietic cell transplantation for Wiskott-Aldrich syndrome: advances in biology and future directions for treatment. Immunol Allergy Clin North Am 2010;30(2):179-194.

  2. Persons DA. The challenge of obtaining therapeutic levels of genetically modified hematopoietic stem cells in betathalassemia patients. Ann NY Acad Sci 2010;1202:69-74.

  3. Roifman CM. Hematopoietic stem cell transplantation for profound T-cell deficiency (combined immunodeficiency). Immunol Allergy Clin North Am 2010;30(2):209-219.

  4. Loren AW, Bunin GR, Boudreau C, et al. Impact of donor and recipient sex and parity on outcomes of HLA-identical sibling allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2006;12(7):758-769.

  5. Wingard JR, Hsu J, Hiemenz JW. Hematopoietic stem cell transplantation: an overview of infection risks and epidemiology. Infect Dis Clin North Am 2010;24(2):257-272.

  6. Adams KM, Holmberg LA, Leisenring W, et al. Risk factors for syngenetic graft-versus-host disease after adult hematopoietic cell transplantation. Blood 2004;104(6):1894-1897.

  7. Cantu-Rodriguez OG, Jaime-Perez JC, Gutierrez-Aguirre CH, et al. Outpatient allografting using non-myeloablative conditioning: the Mexican experience. Bone Marrow Transplant 2007;40(2):119-123.

  8. Gutierrez-Aguirre CH, Cantu-Rodriguez OG, Gonzalez-Llano O, et al. Non-myeloablative hematopoietic stem cell transplantation is of limited value in advanced or refractory acute myeloblastic leukemia. The Mexican experience. Hematology 2007;12(3):193-197.

  9. Gutierrez-Aguirre CH, Gomez-Almaguer D, Cantu-Rodriguez OG, et al. Non-myeloablative stem cell transplantation in patients with relapsed acute lymphoblastic leukemia: results of a multicenter study. Bone Marrow Transplant 2007;40(6):535-539.

  10. Blaise D, Farnault L, Faucher C, et al. Reduced intensity conditioning with fludarabin, oral busulfan and thymoglobulin allows long term disease control and low transplant related mortality in patients with hematological malignancies. Exp Hematol Sep 15 2010.

  11. Liu QF, Xu XJ, Chen YK, et al. Long-term outcomes of HLAmatched sibling compared with mismatched related and unrelated donor hematopoietic stem cell transplantation for chronic phase chronic myelogenous leukemia: a single institution experience in China. Ann Hematol Sep 25 2010.

  12. Stern M, Brand R, de Witte T, et al. Female-versus-male alloreactivity as a model for minor histocompatibility antigens in hematopoietic stem cell transplantation. Am J Transplant 2008;8(10):2149-2157.

  13. Stern M, Passweg JR, Locasciulli A, et al. Influence of donor/ recipient sex matching on outcome of allogeneic hematopoietic stem cell transplantation for aplastic anemia. Transplantation 2006;82(2):218-226.

  14. Busque L, Belisle C, Provost S, Giroux M, Perreault C. Differential expression of SMAD3 transcripts is not regulated by cis-acting genetic elements but has a gender specificity. Genes Immun 2009;10(2):192-196.

  15. Desmarets M, Cadwell CM, Peterson KR, Neades R, Zimring JC. Minor histocompatibility antigens on transfused leukoreduced units of red blood cells induce bone marrow transplant rejection in a mouse model. Blood 2009;114(11):2315-2322.

  16. Markiewicz M, Siekiera U, Karolczyk A, et al. Immunogenic disparities of 11 minor histocompatibility antigens (mHAs) in HLA-matched unrelated allogeneic hematopoietic SCT. Bone Marrow Transplant 2009;43(4):293-300.

  17. Gahrton G, Iacobelli S, Apperley J, et al. The impact of donor gender on outcome of allogeneic hematopoietic stem cell transplantation for multiple myeloma: reduced relapse risk in female to male transplants. Bone Marrow Transplant 2005;35(6):609-617.

  18. Gahrton G. Risk assessment in haematopoietic stem cell transplantation: impact of donor-recipient sex combination in allogeneic transplantation. Best Pract Res Clin Haematol 2007;20(2):219-229.

  19. Gratwohl A, Hermans J, Niederwieser D, van Biezen A, van Houwelingen HC, Apperley J. Female donors influence transplant-related mortality and relapse incidence in male recipients of sibling blood and marrow transplants. Hematol J 2001;2(6):363-370.

  20. Randolph SS, Gooley TA, Warren EH, Appelbaum FR, Riddell SR. Female donors contribute to a selective graft-versusleukemia effect in male recipients of HLA-matched, related hematopoietic stem cell transplants. Blood 2004;103(1):347-352.






>Journals >Revista de Hematología >Year 2011, Issue 1
 

· Journal Index 
· Links 






       
Copyright 2019