Donor characteristics and hematopoietic stem cell transplantation outcome: experience of a single center in Southern Brazil
Paz, Alessandra; Rigoni, Lisandra; Fischer, Gustavo; Schittler, Monise; Pezzi, Annelise; Valim, Vanessa; Dahmer, Alice; Zambonato, Bruna; Amorin, Bruna; Sehn, Filipe; Silva, Maria Aparecida da; Daudt, Liane; Silla, Lucia.
Hematol., Transfus. Cell Ther. (Impr.)
; 40(2): 136-142, Apr.-June 2018. tab, graf
Artigo
em Inglês
| LILACS | ID: biblio-953812
ABSTRACT
Background:
Hematopoietic stem cell transplantation is a curative treatment for many patients with hematological disorders. Donor-recipient genetic disparity, especially involving the human leukocyte antigen system is a critical factor for transplant outcome.Objective:
To evaluate retrospectively donor characteristics and correlations with the occurrence of acute and chronic graft-versus-host disease, disease-free survival and overall survival in a Brazilian population submitted to allogeneic hematopoietic stem cell transplantation between 1994 and 2012 in a single center.Results:
Three hundred and forty-seven consecutive transplantations were included. Related transplants (81.2%) were significantly more common than unrelated transplants (18.7%); donor and recipient median ages were 34 (range 1-61) and 33 (range 3-65) years respectively with donor HLAs being matched for 333 (95.9%) patients. Donor gender, cytomegalovirus status and ABO incompatibility did not influence the five-year overall survival. In univariate analyses, overall survival was negatively influenced by the presence of acute graft-versus-host disease (33% vs. 47%, respectively; p-value = 0.04), unrelated transplant (41.5% vs. 50.9%, respectively; p-value = 0.045) and donors aged over 40 years (41% vs. 52%, respectively; p-value = 0.03). Older donors were associated with a higher rate of acute (52% vs. 65.8%; p-value = 0.03) and chronic graft-versus-host disease (60% vs. 43%, respectively; p-value = 0.015). In multivariate analyses, acute graft-versus-host disease [relative risk (RR) 1.8; 95% confidence interval (CI) 1.1-29; p-value = 0.008] and older donors (RR 1.6; 95% CI 1.11-2.24; p-value = 0.013) were associated with higher transplant-related mortality.Conclusions:
In transplant patients, to have a donor older than 40 years of age seems to significantly increase the incidence of acute and chronic graft-versus-host disease and transplant-related mortality with no impact on disease-free survival and overall survival. In spite of the rather small cohort of patients, these findings are similar to what is described in the literature suggesting that a younger donor should be chosen whenever possible.
Biblioteca responsável:
BR408.1
Localização: BR408.1
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