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Clinical outcome after sex-mismatched allogeneic stem cell transplantation from human lymphocyte antigen-identical sibling donors: influence of stem cell source

Leukemia volume 20, pages 1461–1464 (2006)Cite this article

Granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral blood (PB) is increasingly selected as a source of stem cells for allogeneic transplantation.1 The shift from using bone marrow (BM) to PB stem cells is based on the faster haematological recovery and lower transplant-related mortality (TRM) in patients with advanced disease observed after transplantation with PB.2 However, it remains unclear whether the use of PB is associated with an increased incidence of acute graft-versus-host disease (GvHD). Several retrospective and randomized prospective studies comparing BM and PB found a similar incidence of acute GvHD,2, 3 except the European Group for Blood and Marrow Transplantation (EBMT) study, which seems to indicate that PB transplants are associated with an increased cumulative incidence of acute GvHD.4 This association was recently confirmed by a meta-analysis of nine randomized trials.5 Nevertheless, it seems clear that PB transplants have an increased risk of chronic GvHD.2, 3, 4, 5

Many genes located on the Y-chromosome have been reported to encode male-specific minor histocompatibility antigens (mHags) (SMCY, DFFRY, UTY, DBY), and cytotoxic T-lymphocytes directed against these mHAgs have been found in patients with acute GvHD or graft rejection.6 In fact, many studies have identified the combination male recipient/female donor as a risk factor for both acute and chronic GvHD after human lymphocyte antigen (HLA)-identical sibling donor allogeneic transplantation. Moreover, recipients of HLA-identical but sex-mismatched grafts have higher TRM and a poorer transplantation outcome than those who receive a graft matched for sex.7 However, most of these studies analysed patients receiving BM as a stem cell source.

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Acknowledgements

This work has been financed by Grants FIS PI020148 and FIS PI050939 from the Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III and Ministerio de Sanidad y Consumo. APG is a recipient of a Grant from the Fundació Privada Institut d’Investigació Biomèdica de Bellvitge (IDIBELL).

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Authors and Affiliations

  1. Clinical Hematology Department, Institut Català d’Oncologia, Hospital Durán I Reynals, L’Hospitalet, Barcelona, Spain

    D Gallardo, A Pérez-García & M Encuentra

  2. Hematology Department, Hospital La Princesa, Madrid, Spain

    R de la Cámara

  3. Hematology Department, Hospital Marqués de Valdecilla, Santander, Spain

    A Iriondo

  4. Hematology Department, Hospital Carlos Haya, Málaga, Spain

    A Jiménez-Velasco

  5. Hematology Depatment, Hospital Reina Sofía, Córdoba, Spain

    A Torres

  6. Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    S Brunet

  7. Hematology Department, Hospital Clínic, Barcelona, Spain

    Á Urbano-Ispizúa

  8. Hematology Department, Clínica Puerta de Hierro, Madrid, Spain

    C Vallejo

  9. Hematology Department, Hospital Clínico Universitario, Salamanca, Spain

    D Caballero

  10. Hematology Department, Hospital Virgen del Rocío, Sevilla, Spain

    I Espigado

  11. Hematology Department, Hospital Gregorio Marañón, Madrid, Spain

    D Serrano

  12. Hematology Department, Hospital Vall d’Hebró, Barcelona, Spain

    C Barrenetxea

  13. Hematology Department, Institut Català d’Oncologia, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain

    J M Ribera

  14. Hematology Department, Hospital La Fe, Valencia, Spain

    J de la Rubia

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On behalf of the Allogeneic Peripheral Blood Transplantation Sub-committee of the Spanish Group of Hematopoietic Stem Cell Transplantation (GETH: Grupo Español de Trasplante Hemopoyético)

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Gallardo, D., Pérez-García, A., de la Cámara, R. et al. Clinical outcome after sex-mismatched allogeneic stem cell transplantation from human lymphocyte antigen-identical sibling donors: influence of stem cell source. Leukemia 20, 1461–1464 (2006). https://doi.org/10.1038/sj.leu.2404263

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