Impact of sex incompatibility on the outcome of single-unit cord blood transplantation for adult patients with hematological malignancies

Konuma, Takaaki; Kato, Seiko; Ooi, Jun; Oiwa‐Monna, Maki; Ebihara, Yasuhiro; Mochizuki, Seibu; Kikuchi, Yuji; Ohno, Nobuhiro; Kawamata, Toyotaka; Jo, Norihide; Yokoyama, Kazuaki; Uchimaru, Kaoru; Tojo, Arinobu; Takahashi, Satoshi

doi:10.1038/bmt.2014.10

Cited by 9 publications

(11 citation statements)

References 39 publications

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“…The higher CD34 + cell dose was associated with an increased risk of chronic GVHD in allogeneic PBSCT setting [42,43]. In contrast, the impact of cell number on GVHD is largely unknown in the setting of CBT, although the association between development of GVHD and HLA and gender mismatch has been extensively analyzed [8,28,[44][45][46]. Gluckman et al reported that higher CD34 + cell dose was significantly associated with grade III to IV acute GVHD in singleunit CBT [46].…”

Section: Discussionmentioning

confidence: 99%

Cryopreserved CD34 + Cell Dose, but Not Total Nucleated Cell Dose, Influences Hematopoietic Recovery and Extensive Chronic Graft-versus-Host Disease after Single-Unit Cord Blood Transplantation in Adult Patients

Konuma

Kato

Oiwa‐Monna

et al. 2017

Biology of Blood and Marrow Transplantation

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Low cryopreserved total nucleated cell (TNC) dose in a cord blood (CB) unit has been shown to be associated with engraftment failure and mortality after single-unit cord blood transplantation (CBT) in adults. Although CB banks offer specific characteristics of cryopreserved cell dose, such as TNC, CD34 cells, and colony-forming unit for granulocyte/macrophage (CFU-GM), the impact of each cell dose on engraftment and outcomes after single-unit CBT in adults remains unclear. We retrospectively analyzed the results of 306 CBTs for 261 adult patients in our institution between 1998 and 2016. The median age was 43 years (range, 16 to 68), the median actual body weight (ABW) was 56.2 kg (range, 36.2 to 104.0), the median ideal body weight (IBW) was 62.3 kg (range, 39.7 to 81.3), the median TNC dose was 2.46 × 10/ABW kg (range, 1.07 to 5.69), the median CD34 cell dose was .91 × 10/ABW kg (range, .15 to 7.75), and the median CFU-GM dose was 24.46 × 10/ABW kg (range, .04 to 121.81). Among patients who achieved engraftment, the speed of neutrophil, platelet, and red blood cell engraftment significantly correlated with CD34 cell dose, but not with TNC and CFU-GM dose, based on both ABW and IBW. In multivariate analysis, the incidence of extensive chronic graft-versus-host disease (GVHD) was significantly higher in patients receiving the highest CD34 cell dose, based on both ABW and IBW. Nevertheless, no cell dose was associated with survival, transplantation-related mortality, and relapse. In conclusion, cryopreserved CD34 cell dose was the best predictor for hematopoietic recovery and extensive chronic GVHD after CBT. The cryopreserved CD34 cell dose should be used for unit selection criteria in single-unit CBT for adults.

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Section: Discussionmentioning

confidence: 99%

Cryopreserved CD34 + Cell Dose, but Not Total Nucleated Cell Dose, Influences Hematopoietic Recovery and Extensive Chronic Graft-versus-Host Disease after Single-Unit Cord Blood Transplantation in Adult Patients

Konuma

Kato

Oiwa‐Monna

et al. 2017

Biology of Blood and Marrow Transplantation

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“…An investigation into the impact of cord blood donor sex compatibility has demonstrated no impact on survival in adults with haematological malignancies receiving a myeloablative single unit cord blood transplant. However, a higher incidence of chronic GVHD (HR 2.97, P = 0.02) was observed in male recipients of female cord blood donors and a lower incidence of platelet engraftment (HR 0.56, P = 0.02) in female recipients with male cord blood donors (Konuma et al ., ). These findings require confirmation in further studies.…”

Section: Non‐hla Factors To Be Considered For Related and Unrelated Dmentioning

confidence: 97%

BSHI Guideline: HLA matching and donor selection for haematopoietic progenitor cell transplantation

Little

Green

Harvey

et al. 2016

Int J Immunogenetics

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List of recommendations• All laboratories performing H&I testing for allogeneic HPC transplantation should follow EFI standards and be accreditated by EFI and UKAS/CPA. (Grade 1A)• HLA typing definitions as described by Nunes et al. 2011 and here should be used (Grade 1A)• HLA typing results should use official WHO HLA Nomenclature (Grade 1A)• The clinical urgency should be made available to the individual performing the related and unrelated donor search (Grade 1B)• HLA high resolution typing should be performed on potential matching; mismatching and haploidentical related donors when familial haplotypes cannot be fully assigned (Grade 1A)• Patients and selected related donors should be typed for HLA-A, -B, -C, -DRB1 and -DQB1 (+/-DPB1) (Grade 1A).• All patients and donors must have their HLA type confirmed on a second sample pre-transplant (Grade 1A).• The patient should be high resolution typed prior to submitting the HLA type for an unrelated donor search (Grade 1A)• A 10/10 high resolution HLA-A, -B, -C, -DRB1 and -DQB1 matched unrelated PBSC or bone marrow donor should be used where possible (Grade 1A).• Where a 10/10 matched PBSC or bone marrow donor is not available a single mismatch at HLA-A, -B, -C, -DRB1 or -DQB1 is acceptable (Grade 1A).• Alternative progenitor cell donors (cord blood or haplo-identical) should be considered early in the donor search when a patient is unlikely to have an HLA matched unrelated donor (Grade 1A).• HLA-DRB3, -DRB4, -DRB5 typing should be performed and, when a choice of otherwise equally matched and appropriate (e.g. CMV status) donors is available, mismatches for these should be minimized (Grade 2A). • For unrelated donor selection, HLA-DPB1 typing should be performed and when a choice of otherwise equally matched and appropriate (e.g. CMV status) donors is available, non-permissive mismatches should be minimised (Grade 2C).• For mismatched related and unrelated donor selection, HVG mismatches are favoured over bi-directional and GVH mismatches (Grade 2C).• UCB units should be HLA typed to high resolution HLA-A, -B, -C, -DRB1, -DQB1 (Grade 1B ).• Selection of UCB units should follow national consensus guidelines published by Hough et al. (Grade 1A).• HLA alloantibody testing of the recipient should be performed at the time of donor search and should be repeated at the time of donor work-up request if an HLA mismatched donor is selected (Grade 1A).• The clinical team must be made aware of any HLA alloantibody incompatibility for a selected donor (Grade 1A).• When a choice of equally well matched donors is available, avoid selection of donors against which the patient has HLA alloantibodies (Grade 1A).• HLA alloantibody testing should be performed in cases of failed engraftment if the donor is HLA mismatched (Grade 1B).• The guideline published by Emery et al., 2013 recommending CMV matching between patient and donor should be followed (Grade 1A).• Major ABO incompatibilities should be avoided when there is a choice of HLA and CMV matched donors (Grade 1A)• Male donors ...

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“…Konuma et al . 's study did not show any impact on survival, but did show a higher incidence of chronic GvHD in male recipients of female cord blood donors (HR 2·97, P = 0·02). Finally, a recent analysis by Zhu et al .…”

Section: Donor Sex In Cord Blood Haematopoietic Cell Transplantationmentioning

confidence: 75%

“…To the best of our knowledge, three retrospective studies have examined the impact of donor–recipient sex matching on recipient outcomes following single cord blood transplant for haematologic malignancy . Baron et al .…”

Section: Donor Sex In Cord Blood Haematopoietic Cell Transplantationmentioning

confidence: 99%

Targeted recruitment of male donors for allogeneic haematopoietic cell transplantation: A review of the evidence

2018

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Many patients in need of a haematopoietic cell transplant cannot find a suitable HLA-compatible donor within their families and rely on volunteers who have registered as haematopoietic stem cell donors with a stem cell donor registry. Transplant physicians mostly prefer male donors for their patients when multiple donor options exist, and organizations recruiting donors are actively targeting males in their recruitment efforts. However, significant recruitment of female donors continues worldwide and appears to be increasing. In this review, the evidence underlying transplant physician preference for male donor selection is summarized. The review will inform donor recruitment organizations contemplating a change in strategy to target potential male registrants and will equip donor recruitment staff and volunteers with a resource to better understand their recruitment efforts.

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Impact of sex incompatibility on the outcome of single-unit cord blood transplantation for adult patients with hematological malignancies

Cited by 9 publications

References 39 publications

Cryopreserved CD34 + Cell Dose, but Not Total Nucleated Cell Dose, Influences Hematopoietic Recovery and Extensive Chronic Graft-versus-Host Disease after Single-Unit Cord Blood Transplantation in Adult Patients

Cryopreserved CD34 + Cell Dose, but Not Total Nucleated Cell Dose, Influences Hematopoietic Recovery and Extensive Chronic Graft-versus-Host Disease after Single-Unit Cord Blood Transplantation in Adult Patients

BSHI Guideline: HLA matching and donor selection for haematopoietic progenitor cell transplantation

Targeted recruitment of male donors for allogeneic haematopoietic cell transplantation: A review of the evidence

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