title: Donor characteristics affecting graft failure, graft-versus-host disease, and survival after unrelated donor transplantation with reduced-intensity conditioning for hematologic malignancies.
abstract: We examined the effect of donor characteristics on graft failure (<5% donor chimerism within 3 months after transplantation), acute and chronic graft-versus-host disease (aGVHD, cGVHD), and survival after unrelated donor reduced-intensity conditioning (RIC) transplantation in 709 patients with hematologic malignancies. Donor-recipient pairs were HLA typed at HLA-A, -B, -C, and -DRB1 (allele-level). A total of 501 patients were >95% donor chimerism, 145 patients were 5% to 95%, and 63 patients were <5%. The only donor characteristic associated with transplantation outcome was donor-recipient HLA matching. One- or 2-loci mismatched transplants led to higher grade 2-4 (relative risk [RR] = 1.27, P = .035) and grade 3-4 (RR = 1.85, P < .001) aGVHD and 2-loci mismatched transplants higher mortality (RR = 2.22, P < .001). Graft failure was higher after transplantation of bone marrow (RR = 2.33, P = .002). Donor age, parity, and donor sex match were not associated with transplantation outcome. Donor-recipient HLA matching is the only donor characteristic predictive for survival after RIC regimens for hematologic malignancies.
authors.affiliation: University Hospital Basel, Basel, Switzerland.
authors.forename: Jakob R
authors.initials: JR
authors.lastname: Passweg
authors.forename: Mei-Jie
authors.initials: MJ
authors.lastname: Zhang
authors.forename: Vanderson
authors.initials: V
authors.lastname: Rocha
authors.forename: Fangyu
authors.initials: F
authors.lastname: Kan
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.forename: Luis M
authors.initials: LM
authors.lastname: Isola
authors.forename: Adrian P
authors.initials: AP
authors.lastname: Gee
authors.forename: John
authors.initials: J
authors.lastname: Gibson
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Laughlin
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.forename: Alison
authors.initials: A
authors.lastname: Loren
authors.forename: David I
authors.initials: DI
authors.lastname: Marks
authors.forename: Alois
authors.initials: A
authors.lastname: Gratwohl
authors.forename: Mary
authors.initials: M
authors.lastname: Eapen
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D006086:Graft vs Host Disease / Q000276:immunology*; D019337:Hematologic Neoplasms / Q000276:immunology / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D014184:Transplantation, Homologous / Q000276:immunology; D061349:Unrelated Donors; D055815:Young Adult