Can a female donor for a male recipient decrease the relapse rate for patients with acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation?

Piyanuch Kongtim, Antonio Di Stasi, Gabriela Rondon, Julianne Chen, Kehinde Adekola, Uday Popat, Betul Oran, Partow Kebriaei, Borje S. Andersson, Richard E. Champlin, Stefan O. Ciurea*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

The mismatched minor histocompatibility antigens present on Y chromosome (H-Y) in male recipients receiving stem cells from female donors may contribute to the graft-versus-leukemia effect and results in a reduced relapse rate, especially in patients with high-risk disease. We retrospectively compared the outcomes of male patients with acute myeloid leukemia who received an allogeneic hematopoietic stem cell transplant (HSCT) from female donors (F-M) (174 patients) versus other gender combinations (667 patients). Median age was 50years (range, 18 to 74years). For the whole group, the 1-year cumulative incidence of relapse was significantly lower in F-M group (34.1% versus 41.3%, P= .044), whereas nonrelapse mortality (NRM) was higher (23.2% versus 15.7%, P= .004). For patients younger than 50years beyond first complete remission, the F-M group was associated with lower relapse rate (42.5% versus 55.2%, P= .045) whereas NRM was not significantly different (35.8% versus 25.5%, P= .141). Although survival was not significantly improved, transplantation from a female donor for male recipient was associated with a lower relapse rate. When relapse is the most common concern for treatment failure, especially for younger patients, a female donor for a male recipient might be beneficial to decrease relapse rate after transplantation. Future studies are needed to explore how the H-Y mismatch may improve survival after transplantation.

Original languageEnglish (US)
Pages (from-to)713-719
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number4
DOIs
StatePublished - Apr 1 2015

Keywords

  • Busulfan conditioning
  • Graft-versus-host disease
  • Graft-versus-leukemia effect
  • Hematopoietic stem cell transplantation
  • Minor histocompatibility antigens

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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