Olle Ringden, MD, PhD
,
Division of Therapeutic Immunology and Center for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Stockholm, Sweden
Myriam Labopin, MD
,
Service d’Hématologie et Thérapie Cellulaire, AP-HP, UPMC Université Paris 6, UMR-S 938, CEREST-TC EBMT, Hôpital Saint Antoine, Paris, France
Martin Solders, MD
,
Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden
Dietrich W. Beelen, MD
,
University Hospital of Essen, Essen, Germany
Renate Arnold, MD
,
Hematology, Oncology and Tumor Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
Gerhard Ehninger
,
Medizinisch e Klinik und Poliklinik I, Universitaetskinikum Dresden, Dresden, Germany
Noel Milpied
,
BMT unit, CHU Bordeaux, Bordeaux, France
Dietger Niederwieser, MD
,
University of Leipzig, Leipzig, Germany
Rose-Marie Hamladji, MD, PhD
,
Center Pierre et Marie Curie, Alger, Algeria
Arnold Ganser, MD
,
Dept. of Hematology/Oncology, Medizinische Hochschule Hannover, Hannover, Germany
Gerard Socié, MD, PhD
,
Hematology/Transplantation, Hospital Saint Louis, Paris, France
Matthias Stelljes
,
University of Münster, Münster, Germany
Liisa Volin, MD
,
Third Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
Charles Craddock
,
Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, United Kingdom
Mohamad Mohty
,
Hematology Dpt, CHU de Nantes - Hotel-Dieu, Nantes, ., France
Background. Female donors for male recipients worsens outcome of allogeneic haematopoietic stem cell transplantation (HSCT). We wanted to find out whether a male HLA-matched unrelated donor (MUD, 8/8, n=2,014) might be an alternative to a female HLA-identical sibling donor (n=2,656) for males with acute leukaemia.
Methods. A retrospective analysis from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation.
Results. The relative risk (RR) of acute GVHD of grades II–IV was increased in the MUD group with acute myeloid leukaemia (AML) (RR 1.47, p<0.001) and acute lymphoblastic leukaemia (ALL) (RR 1.76, p<0.001). There was no difference in incidence of chronic GVHD and non-relapse mortality between the two groups. Probability of relapse was lower in the MUD group than in the sibling group in ALL patients (HR 0.75, p=0.04) but not in AML patients (HR 0.89, p=0.17). Survival was not different between the groups. Leukaemia-free survival (LFS) was also similar in the sibling and MUD groups in patients with AML (HR 1.01, p=0.81) or ALL (HR 0.93, p=0.45). Factors significantly associated with reduced LFS included active disease, poor cytogenetics, age, year of HSCT, reduced-intensity conditioning, and the use of anti-thymocyte globulin.
Conclusion. Male patients who received grafts from male MUDs had an increased incidence of acute GVHD and the same LFS as when using HLA-identical female donors.
