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2011, Number 1

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Rev Hematol Mex 2011; 12 (1)

Significance of sex disparity between donor and recipient in allogeneic stem cell transplantation using a reduced-intensity conditioning

Gutiérrez ACH, Borjas AOD, Cantú ROG, González LO, Jaime PJC, Gómez AD

Language: Spanish
References: 20
Page: 17-22
PDF size: 91.33 Kb.


ABSTRACT

Background: Allogeneic hematopoietic stem cell transplantation (HSCT) from a compatible HLA donor is the procedure of choice for the treatment of diverse neoplasic and non-neoplasic hematologic diseases. Some studies have found a higher incidence of graft versus host disease (GVHD) and rejection when there is sex disparity between donor and recipient. In this study we analyzed the incidence of GVHD and survival of patients receiving a reduced-intensity HSCT from donors with or without sex disparity.
Materials and Methods: We included 56 patients who underwent reduced intensity conditioning before allogeneic HSCT regardless of the underlying disease. Twenty nine patients were sex-matched with the donors and in 27 patients sex disparity between donor and recipient existed. The median follow-up was 34 months. Each patient received a reduced intensity conditioning with cyclophosphamide, busulfan and fludarabine; prophylaxis for GVHD included cyclosporine and methotrexate.
Results: The median dose of CD34+ infused was of 5.9 (±2.3) x 106 per kg of weight. Survival was higher in the group of patients with a donor of different sex (88% vs 79%), although without statistic significance (p=.209). The incidence of acute and chronic GVHD in the group of patients with same-sex donor was 31% and 17.2% respectively, while in the group of different sex it was 26% and 33.2% respectively, with no statistic significance. (p=.42 and p=.09 respectively). Complete chimerism was 58% in the no sex disparity group, significantly higher than 18.5% in the sex mistmached group (p=.004).
Conclusion: Sex disparity between donor and recipient had no influence in the incidence of GVHD and had not a measurable effect on survival. Ideally, a donor on the same sex as the receptor, if reduced intensity allogeneic hematopoietic stem cell transplantation is used, should be choose since there is a higher chance of achieve a complete chimerism.


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