TY - JOUR
T1 - Graft-versus-Host Disease after HLA-Matched Sibling Bone Marrow or Peripheral Blood Stem Cell Transplantation
T2 - Comparison of North American Caucasian and Japanese Populations
AU - Kanda, Junya
AU - Brazauskas, Ruta
AU - Hu, Zhen Huan
AU - Kuwatsuka, Yachiyo
AU - Nagafuji, Koji
AU - Kanamori, Heiwa
AU - Kanda, Yoshinobu
AU - Miyamura, Koichi
AU - Murata, Makoto
AU - Fukuda, Takahiro
AU - Sakamaki, Hisashi
AU - Kimura, Fumihiko
AU - Seo, Sachiko
AU - Aljurf, Mahmoud
AU - Yoshimi, Ayami
AU - Milone, Giuseppe
AU - Wood, William A.
AU - Ustun, Celalettin
AU - Hashimi, Shahrukh
AU - Pasquini, Marcelo
AU - Bonfim, Carmem
AU - Dalal, Jignesh
AU - Hahn, Theresa
AU - Atsuta, Yoshiko
AU - Saber, Wael
N1 - Funding Information:
This work was supported in part by the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from Japan Agency for Medical Research and Development.
Publisher Copyright:
© 2016 American Society for Blood and Marrow Transplantation.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - The risk of acute graft-versus-host disease (GVHD) after HLA-matched sibling bone marrow transplantation (BMT) is lower in Japanese than in Caucasian patients. However, race may have differential effect on GVHD dependent on the graft source. North American Caucasian and Japanese patients receiving their first allogeneic BMT or peripheral blood stem cell transplantation from an HLA-matched sibling for leukemia were eligible. BMT was performed in 13% of the Caucasian patients and in 53% of the Japanese patients. On multivariate analysis, the interaction term between race and graft source was not significant in any of the models, indicating that graft source does not affect the impact of race on outcomes. The risk of grade III or IV acute GVHD was significantly lower in the Japanese patients compared with the Caucasian patients (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.57 to 0.96), which resulted in lower risk of nonrelapse mortality in the Japanese patients (HR, 0.69; 95% CI, 0.54 to 0.89). The risk of relapse was also lower in this group. The lower risks of nonrelapse mortality and relapse resulted in lower overall mortality rates among the Japanese patients. In conclusion, our data indicate that irrespective of graft source, the risk of severe acute GVHD is lower in Japanese patients, resulting in a lower risk of nonrelapse mortality.
AB - The risk of acute graft-versus-host disease (GVHD) after HLA-matched sibling bone marrow transplantation (BMT) is lower in Japanese than in Caucasian patients. However, race may have differential effect on GVHD dependent on the graft source. North American Caucasian and Japanese patients receiving their first allogeneic BMT or peripheral blood stem cell transplantation from an HLA-matched sibling for leukemia were eligible. BMT was performed in 13% of the Caucasian patients and in 53% of the Japanese patients. On multivariate analysis, the interaction term between race and graft source was not significant in any of the models, indicating that graft source does not affect the impact of race on outcomes. The risk of grade III or IV acute GVHD was significantly lower in the Japanese patients compared with the Caucasian patients (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.57 to 0.96), which resulted in lower risk of nonrelapse mortality in the Japanese patients (HR, 0.69; 95% CI, 0.54 to 0.89). The risk of relapse was also lower in this group. The lower risks of nonrelapse mortality and relapse resulted in lower overall mortality rates among the Japanese patients. In conclusion, our data indicate that irrespective of graft source, the risk of severe acute GVHD is lower in Japanese patients, resulting in a lower risk of nonrelapse mortality.
KW - Bone marrow transplantation
KW - Graft-versus-host disease
KW - Peripheral blood stem cell transplantation
KW - Race
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U2 - 10.1016/j.bbmt.2015.12.027
DO - 10.1016/j.bbmt.2015.12.027
M3 - Article
C2 - 26762681
AN - SCOPUS:84960476841
SN - 1083-8791
VL - 22
SP - 744
EP - 751
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 4
ER -