BM is preferred over PBSCs in transplantation from an HLA-matched related female donor to a male recipient

Hideki Nakasone, Koji Kawamura, Kimikazu Yakushijin, Akihito Shinohara, Masatsugu Tanaka, Kazuteru Ohashi, Shuichi Ota, Naoyuki Uchida, Takahiro Fukuda, Hirohisa Nakamae, Ken-ichi Matsuoka, Junya Kanda, Tatsuo Ichinohe, Yoshiko Atsuta, Yoshihiro Inamoto, Sachiko Seo, Fumihiko Kimura, Masao Ogata

Research output: Contribution to journalArticle

Abstract

The use of granulocyte colony-stimulating factor-mobilized peripheral blood stem cells (PBSCs) and sex-mismatched hematopoietic cell transplantation (HCT), especially with female donors and male recipients (FtoM), is known to be associated with an increased risk of chronic graft-versus-host disease (GVHD) compared with transplantation with bone marrow (BM). This raises the question of whether the use of PBSCs in FtoM HCT might affect allogeneic responses, resulting in fatal complications. Using a Japanese transplantation registry database, we analyzed 1132 patients (FtoM, n 5 315; MtoF, n 5 260; sex-matched, n 5 557) with standard-risk diseases who underwent HCT with an HLA-matched related donor without in vivo T-cell depletion between 2013 and 2016. The impact of PBSC vs BM on transplantation outcomes was separately assessed in FtoM, MtoF, and sex-matched HCT. Overall survival (OS) and nonrelapse mortality (NRM) at 2 years post-HCT were significantly worse in patients with PBSCs vs those with BM in FtoM HCT (2-year OS, 76% vs 62%; P 5 .0084; 2-year NRM, 10% vs 21%; P 5 .0078); no differences were observed for MtoF or sex-matched HCT. Multivariate analyses confirmed the adverse impact of PBSCs in FtoM HCT (hazard ratio [HR] for OS, 1.91; P 5 .025; HR for NRM, 3.70; P 5 .0065). In FtoM HCT, patients with PBSCs frequently experienced fatal GVHD and organ failure. In conclusion, the use of PBSCs in FtoM HCT was associated with an increased risk of NRM in the early phase, resulting in inferior survival. This suggests that, when we use female-related donors for male patients in HCT, BM may result in better outcomes than PBSCs.

Original languageEnglish
Pages (from-to)1750-1760
Number of pages11
JournalBlood Advances
Volume3
Issue number11
DOIs
Publication statusPublished - Jun 11 2019

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Peripheral Blood Stem Cell Transplantation
Cell Transplantation
Bone Marrow
Tissue Donors
Bone Marrow Transplantation
Survival
Mortality
Graft vs Host Disease
Peripheral Blood Stem Cells
Granulocyte Colony-Stimulating Factor
Registries
Multivariate Analysis
Transplantation
Databases
T-Lymphocytes

ASJC Scopus subject areas

  • Medicine(all)

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Nakasone, H., Kawamura, K., Yakushijin, K., Shinohara, A., Tanaka, M., Ohashi, K., ... Ogata, M. (2019). BM is preferred over PBSCs in transplantation from an HLA-matched related female donor to a male recipient. Blood Advances, 3(11), 1750-1760. https://doi.org/10.1182/bloodadvances.2019000077

BM is preferred over PBSCs in transplantation from an HLA-matched related female donor to a male recipient. / Nakasone, Hideki; Kawamura, Koji; Yakushijin, Kimikazu; Shinohara, Akihito; Tanaka, Masatsugu; Ohashi, Kazuteru; Ota, Shuichi; Uchida, Naoyuki; Fukuda, Takahiro; Nakamae, Hirohisa; Matsuoka, Ken-ichi; Kanda, Junya; Ichinohe, Tatsuo; Atsuta, Yoshiko; Inamoto, Yoshihiro; Seo, Sachiko; Kimura, Fumihiko; Ogata, Masao.

In: Blood Advances, Vol. 3, No. 11, 11.06.2019, p. 1750-1760.

Research output: Contribution to journalArticle

Nakasone, H, Kawamura, K, Yakushijin, K, Shinohara, A, Tanaka, M, Ohashi, K, Ota, S, Uchida, N, Fukuda, T, Nakamae, H, Matsuoka, K, Kanda, J, Ichinohe, T, Atsuta, Y, Inamoto, Y, Seo, S, Kimura, F & Ogata, M 2019, 'BM is preferred over PBSCs in transplantation from an HLA-matched related female donor to a male recipient', Blood Advances, vol. 3, no. 11, pp. 1750-1760. https://doi.org/10.1182/bloodadvances.2019000077
Nakasone, Hideki ; Kawamura, Koji ; Yakushijin, Kimikazu ; Shinohara, Akihito ; Tanaka, Masatsugu ; Ohashi, Kazuteru ; Ota, Shuichi ; Uchida, Naoyuki ; Fukuda, Takahiro ; Nakamae, Hirohisa ; Matsuoka, Ken-ichi ; Kanda, Junya ; Ichinohe, Tatsuo ; Atsuta, Yoshiko ; Inamoto, Yoshihiro ; Seo, Sachiko ; Kimura, Fumihiko ; Ogata, Masao. / BM is preferred over PBSCs in transplantation from an HLA-matched related female donor to a male recipient. In: Blood Advances. 2019 ; Vol. 3, No. 11. pp. 1750-1760.
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abstract = "The use of granulocyte colony-stimulating factor-mobilized peripheral blood stem cells (PBSCs) and sex-mismatched hematopoietic cell transplantation (HCT), especially with female donors and male recipients (FtoM), is known to be associated with an increased risk of chronic graft-versus-host disease (GVHD) compared with transplantation with bone marrow (BM). This raises the question of whether the use of PBSCs in FtoM HCT might affect allogeneic responses, resulting in fatal complications. Using a Japanese transplantation registry database, we analyzed 1132 patients (FtoM, n 5 315; MtoF, n 5 260; sex-matched, n 5 557) with standard-risk diseases who underwent HCT with an HLA-matched related donor without in vivo T-cell depletion between 2013 and 2016. The impact of PBSC vs BM on transplantation outcomes was separately assessed in FtoM, MtoF, and sex-matched HCT. Overall survival (OS) and nonrelapse mortality (NRM) at 2 years post-HCT were significantly worse in patients with PBSCs vs those with BM in FtoM HCT (2-year OS, 76{\%} vs 62{\%}; P 5 .0084; 2-year NRM, 10{\%} vs 21{\%}; P 5 .0078); no differences were observed for MtoF or sex-matched HCT. Multivariate analyses confirmed the adverse impact of PBSCs in FtoM HCT (hazard ratio [HR] for OS, 1.91; P 5 .025; HR for NRM, 3.70; P 5 .0065). In FtoM HCT, patients with PBSCs frequently experienced fatal GVHD and organ failure. In conclusion, the use of PBSCs in FtoM HCT was associated with an increased risk of NRM in the early phase, resulting in inferior survival. This suggests that, when we use female-related donors for male patients in HCT, BM may result in better outcomes than PBSCs.",
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AU - Nakasone, Hideki

AU - Kawamura, Koji

AU - Yakushijin, Kimikazu

AU - Shinohara, Akihito

AU - Tanaka, Masatsugu

AU - Ohashi, Kazuteru

AU - Ota, Shuichi

AU - Uchida, Naoyuki

AU - Fukuda, Takahiro

AU - Nakamae, Hirohisa

AU - Matsuoka, Ken-ichi

AU - Kanda, Junya

AU - Ichinohe, Tatsuo

AU - Atsuta, Yoshiko

AU - Inamoto, Yoshihiro

AU - Seo, Sachiko

AU - Kimura, Fumihiko

AU - Ogata, Masao

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