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.
Bibliographical noteFunding 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.
Financial disclosure: The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement 5U24-CA076518 from the National Cancer Institute (NCI) , the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID) ; a Grant/Cooperative Agreement 5U10HL069294 from NHLBI and NCI ; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS) ; two Grants N00014-13-1-0039 and N00014-14-1-0028 from the Office of Naval Research ; and grants from Alexion ; * Amgen, Inc. ; Anonymous donation to the Medical College of Wisconsin; Be the Match Foundation ; * Bristol Myers Squibb Oncology ; * Celgene Corporation ; * Chimerix, Inc. ; Fred Hutchinson Cancer Research Center ; Gamida Cell Ltd. ; Genentech, Inc. ; Genzyme Corporation ; * Gilead Sciences, Inc. ; Health Research, Inc. Roswell Park Cancer Institute ; HistoGenetics, Inc. ; Incyte Corporation ; * Jazz Pharmaceuticals, Inc. ; Jeff Gordon Children's Foundation ; The Leukemia & Lymphoma Society ; The Medical College of Wisconsin ; Merck & Co, Inc. ; Mesoblast ; * Millennium: The Takeda Oncology Co. ; * Miltenyi Biotec, Inc. ; National Marrow Donor Program ; Neovii Biotech NA, Inc. ; Novartis Pharmaceuticals Corporation ; Onyx Pharmaceuticals ; Optum Healthcare Solutions, Inc. ; Otsuka America Pharmaceutical, Inc. ; Otsuka Pharmaceutical Co, Ltd. – Japan ; Oxford Immunotec ; Perkin Elmer, Inc. ; Pharmacyclics ; * Sanofi US ; Seattle Genetics ; Sigma-Tau Pharmaceuticals ; * Spectrum Pharmaceuticals, Inc. ; St. Baldrick's Foundation ; * Sunesis Pharmaceuticals, Inc. ; Swedish Orphan Biovitrum, Inc. ; Telomere Diagnostics, Inc. ; TerumoBCT ; Therakos, Inc. ; University of Minnesota ; and * Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the US Government.
- Bone marrow transplantation
- Graft-versus-host disease
- Peripheral blood stem cell transplantation