Impact of the combination of donor age and HLA disparity on the outcomes of unrelated bone marrow transplantation View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-05-14

AUTHORS

Sachiko Seo, Yoshiaki Usui, Keitaro Matsuo, Yoshiko Atsuta, Aiko Igarashi, Takahiro Fukuda, Yukiyasu Ozawa, Yuta Katayama, Shuro Yoshida, Naoyuki Uchida, Tadakazu Kondo, Shinichi Kako, Nobuhiro Tsukada, Shunichi Kato, Makoto Onizuka, Tatsuo Ichinohe, Fumihiko Kimura, Yoshinobu Kanda, Koichi Miyamura, Junya Kanda

ABSTRACT

Impact of donor age considering HLA disparity on hematopoietic cell transplantation (HCT) outcomes has not been fully evaluated. We evaluated 8486 patients who received unrelated bone marrow transplantation (UR-BMT) from 8/8 or 7/8 HLA-matched donors. Compared to 8/8 HLA-matched younger donors (<40 years), 8/8 HLA-matched older donors (subdistribution hazard ratio [SHR], 1.16; 95% CI, 0.97–1.38) and 7/8 HLA-matched younger donors (SHR, 1.33; 95% CI, 1.11–1.58) were associated with increased risk of grade III–IV acute graft-versus-host disease (aGVHD). 7/8 HLA-matched older donors had further increased risk (SHR, 2.00; 95% CI, 1.68–2.38) due to interaction between donor age and HLA disparity (p for interaction = 0.038). Progression-free survival (PFS) after UR-BMT with 8/8 HLA-matched younger donors was comparable to that after UR-BMT with 8/8 HLA-matched older donors, whereas UR-BMT with 7/8 HLA-matched younger or older donors was significantly associated with lower PFS than UR-BMT with 8/8 HLA-matched younger donors (younger donor; HR, 1.12; 95% CI, 1.04–1.21, older donor; HR, 1.28; 95% CI, 1.17–1.40; p for interaction = 0.079). In conclusion, adverse effect of increased donor age requires attention, especially in HLA-mismatched UR-BMT due to interaction between donor age and HLA disparity. Intensive aGVHD prophylaxis may be required to improve outcomes after HCT with mismatched older donors. More... »

PAGES

2410-2422

Journal

TITLE

Bone Marrow Transplantation

ISSUE

10

VOLUME

56

Author Affiliations

  • Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
  • Division of Cancer Information and Control, Aichi Cancer Center Research Institute, Aichi, Japan
  • Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Aichi, Japan
  • Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Aichi, Japan
  • Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
  • Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
  • Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
  • Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
  • Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
  • Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Tokyo, Japan
  • Department of Hematology and Oncology, Kyoto University, Kyoto, Japan
  • Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
  • Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
  • Department of Innovative Medical Science, Tokai University School of Medicine, Kanagawa, Japan
  • Department of Hematology/Oncology, Tokai University School of Medicine, Kanagawa, Japan
  • Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Division of Hematology, National Defense Medical College, Tokorozawa, Japan
  • Division of Hematology, Jichi Medical University, Tochigi, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41409-021-01289-8

    DOI

    http://dx.doi.org/10.1038/s41409-021-01289-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1138063170

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33990702


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