Impact of the combination of donor age and HLA disparity on the outcomes of unrelated bone marrow transplantation.
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
18
11
2020
accepted:
29
03
2021
revised:
18
03
2021
pubmed:
16
5
2021
medline:
14
10
2021
entrez:
15
5
2021
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 33990702
doi: 10.1038/s41409-021-01289-8
pii: 10.1038/s41409-021-01289-8
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2410-2422Investigateurs
Hiroatsu Ago
(H)
Yoshiko Atsuta
(Y)
Kiyotoshi Imai
(K)
Naoyuki Uchida
(N)
Koji Kato
(K)
Shuichi Kato
(S)
Yoshinobu Kanda
(Y)
Junya Kanda
(J)
Yachiyo Kuwatsuka
(Y)
Takeshi Kobayashi
(T)
Masashi Sawa
(M)
Kazutaka Sunami
(K)
Sachiko Seo
(S)
Masatsugu Tanaka
(M)
Shuichi Taniguchi
(S)
Ken Tabuchi
(K)
Nobuhiro Tsukada
(N)
Seitaro Terakura
(S)
Yasuyuki Nagata
(Y)
Satoshi Nishiwaki
(S)
Naoto Fujita
(N)
Ryosuke Matsuno
(R)
Kimikazu Matsumoto
(K)
Shin Mitamura
(S)
Koichi Miyamura
(K)
Yasuo Morishima
(Y)
Kimikazu Yakushijin
(K)
Syudai Watanabe
(S)
Ken Ishiyama
(K)
Fumihiko Kimura
(F)
Koji Nagafuji
(K)
Toshio Yabe
(T)
Nobuhiko Imahashi
(N)
Yasuhito Nannya
(Y)
Moritaka Goto
(M)
Takaaki Konuma
(T)
Rentaro Miyao
(R)
Naoki Kurita
(N)
Yoshihiro Inamoto
(Y)
Shinichi Kobayashi
(S)
Koji Kawamura
(K)
Tsunehiko Komatsu
(T)
Kazuma Oyashiki
(K)
Keisuke Kato
(K)
Kentaro Kohno
(K)
Tsuneaki Hirakawa
(T)
Shinichiro Fujiwara
(S)
Jiro Inagaki
(J)
Masahito Tokunaga
(M)
Tatsunori Goto
(T)
Ayaka Kobayashi
(A)
Yasuhiko Shibasaki
(Y)
Shin Tagami
(S)
Hiromi Hayashi
(H)
Masahiro Hirayama
(M)
Mizuki Watanabe
(M)
Hiroo Araie
(H)
Taiki Ando
(T)
Yosuke Okada
(Y)
Seiko Kato
(S)
Yuki Takeuchi
(Y)
Takahir Fujino
(T)
Takaya Mitsuyoshi
(T)
Yoshiaki Usui
(Y)
Motoki Okabe
(M)
Keisuke Kataoka
(K)
Miyo Goto
(M)
Leo Tanoshima
(L)
Hirofumi Yokota
(H)
Jun Iwasaki
(J)
Fumiya Wada
(F)
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Limited.
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