title: Increased acute GvHD and higher transplant-related mortality in non-caucasians undergoing standard sibling allogeneic stem cell transplantation.
abstract: We conducted a retrospective study to compare outcome in Caucasians and non-Caucasians undergoing standard sibling allogeneic SCT. End points of the study were to compare graft-versus-host disease (GvHD) occurrence and transplant-related mortality (TRM). There were 251 patients, 43 non-Caucasian and 208 Caucasian. A higher proportion of non-Caucasian patients developed acute GvHD (aGvHD) grade 2 or greater as compared to the Caucasian group (48 vs 26%, respectively) P = 0.02. With a median follow-up of 27 months, 26% (11/43) of non-Caucasians and 14% (29/208) of Caucasian patients had died from TRM, which accounted for 55% of all deaths in the non-Caucasian group compared to 33% in Caucasians, P = 0.02. Overall survival 12 months post transplant was 64 vs 69% in the non-Caucasian and Caucasian groups, respectively (P = 0.43). Although there were higher numbers of CMV-positive patients in the non-Caucasian group, there were no deaths from CMV reactivation in this subgroup. We conclude that there is increased TRM and aGvHD following standard sibling allograft in the non-Caucasian population and this could be due to either differences in tumour biology or extrinsic factors such as socio-economic factors, nutritional status, post transplant care or presenting with late stage disease.
authors.affiliation: Bone Marrow Transplant Unit, University Hospital Birmingham NHS Trust, Birmingham, UK.
authors.forename: M
authors.initials: M
authors.lastname: Karanth
authors.forename: G
authors.initials: G
authors.lastname: Begum
authors.forename: M
authors.initials: M
authors.lastname: Cook
authors.forename: S
authors.initials: S
authors.lastname: Lawson
authors.forename: C
authors.initials: C
authors.lastname: Porter
authors.forename: N
authors.initials: N
authors.lastname: Lister
authors.forename: J
authors.initials: J
authors.lastname: Gray
authors.forename: P
authors.initials: P
authors.lastname: Darbyshire
authors.forename: C
authors.initials: C
authors.lastname: Craddock
authors.forename: P
authors.initials: P
authors.lastname: Mahendra
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D044466:Asian People; D044383:Black People; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000453:epidemiology* / Q000209:etiology; D006402:Hematologic Diseases / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D035781:Siblings; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D044465:White People