High non-relapse mortality and low relapse incidence in gender-mismatched allogeneic hematopoietic stem cell transplantation from a parous female donor with a male child

Abstract

To clarify the influence of exposure to a male fetus during a female donor’s (FD) pregnancy in allogeneic hematopoietic stem cell transplantation (HSCT), we retrospectively examined 292 HSCT patients. The 5-year non-relapse mortality (NRM) was 33.5% among 31 male recipients who had HSCT from FD with a male child (MC), 23.0% among 40 male recipients who had HSCT from FD without MC and 19.6% among 221 other recipients. The 5-year relapse incidence (RI) was 22.6%, 42.0%, and 43.1% for the respective group. In multivariate analysis, male recipients who had HSCT from FD with MC had an increased risk of NRM (hazard ratio [HR] 1.92, 95% CI 1.08–3.42, p = .03), a reduced risk of RI (HR 0.42, 95% CI 0.18–0.96, p = .04), resulting in no significant difference regarding overall survival. Male child of FD is suggested to influence NRM and RI in gender-mismatched HSCT.

Keywords:

• Gender-mismatched allogeneic hematopoietic stem cell transplantation
• immune response
• graft-versus-host disease
• graft-versus-tumor effect

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at http://dx.doi.org/10.1080/10428194.2016.1205743.

Funding information

This work was supported by grants from the Japanese Ministry of Health, Labour and Welfare, and the National Cancer Research and Development Fund (26-A-26).