title: Unrelated cord blood transplantation for adult patients with acute myeloid leukemia: higher incidence of acute graft-versus-host disease and lower survival in male patients transplanted with female unrelated cord blood--a report from Eurocord, the Acute Leukemia Working Party, and the Cord Blood Committee of the Cellular Therapy and Immunobiology Working Party of the European Group for Blood and Marrow Transplantation.
abstract: BACKGROUND
  In the setting of allogeneic human leukocyte antigen (HLA)-matched bone marrow transplantation, transplanting male patients with grafts from female donors has been associated with a higher incidence of graft-versus-host disease (GVHD) and of nonrelapse mortality (NRM). The aim of the current analysis was to compare transplantation outcomes in male patients given female unrelated cord blood (UCB) versus other gender combinations.
  
  
  METHODS
  Data from 552 consecutive patients with acute myeloid leukemia (AML) given a single UCB transplantation between 2000 and 2014 were included.
  
  
  RESULTS
  In comparison with other gender combination, male patients given female UCB (n = 131) had a trend for a higher incidence of grades II-IV acute GVHD (33 versus 25 %, P = 0.08), a trend for a higher incidence of NRM (41 versus 33 %, P = 0.06), and a lower leukemia-free (LFS, 30 versus 41 %, P = 0.01) and overall survival (OS, 33 versus 45 %, P = 0.008). In multivariate analyses, taking into consideration all patients for which data on HLA-matching and cell dose transplanted were fully available (n = 363), male patients transplanted with a female UCB had a trend for a higher incidence of grade III-IV acute GVHD (hazard ratio (HR) = 2.0, P = 0.06), a trend for a higher NRM (HR = 1.5, P = 0.06), and a worse LFS (HR = 1.4, P = 0.04) and OS (HR = 1.3, P = 0.06).
  
  
  CONCLUSIONS
  Our data suggest that male patients transplanted with female UCB might have higher risk of acute GVHD and of NRM leading to worse LFS and OS. These results should be confirmed in other large cohorts of patients before used for determining the choice of an UCB unit.
authors.affiliation: Department of Hematology, University of Liège, CHU Sart-Tilman, 4000, Liège, Belgium. f.baron@ulg.ac.be.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Baron
authors.affiliation: EBMT Paris Office, Hospital Saint Antoine, Paris, France. myriam.labopin@upmc.fr.
authors.forename: Myriam
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France. annalisa.ruggeri@sat.aphp.fr.|AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France. annalisa.ruggeri@sat.aphp.fr.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Ruggeri
authors.affiliation: AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France. mohamad.mohty@inserm.fr.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Hospital Universitario La Fe - Servicio de Hematologia, Valencia, Spain. sanz_gui@gva.es.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Sanz
authors.affiliation: CHU Bordeaux - Hôpital Haut-leveque, Pessac, France. noel.milpied@chu-bordeaux.fr.
authors.forename: Noel
authors.initials: N
authors.lastname: Milpied
authors.affiliation: Department of Haematology II, Ospedale San Martino, Genova, Italy. andrea.bacigalupo@hsanmartino.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bacigalupo
authors.affiliation: Azienda Ospedaliera Papa Giovanni XXIII-Hematology and Bone Marrow Transplant Unit, Bergamo, Italy. arambaldi@hpg23.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rambaldi
authors.affiliation: Institute of Hematology and Medical, Oncology L and A Seràgnoli, S.Orsola-Malpighi Hospital, Bologna University, Bologna, Italy. francesca.bonifazi@unibo.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bonifazi
authors.affiliation: BMT Unit Department of Hematology, Ospedale di Careggi, Firenze, Italy. alberto.bosi@unifi.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
authors.affiliation: Hematology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain. JSierra@santpau.cat.
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
authors.affiliation: Hôpital HURIEZ - UAM allo-CSH - CHRU, Lille, France. i-yakoub-agha@orange.fr.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yakoub-Agha
authors.affiliation: ICO-Hospital Universitari Germans Trias i Pujol, Jose Carreras Research Institute, Barcelona, Spain. jribera@iconcologia.net.
authors.forename: Josep Maria Ribera
authors.initials: JM
authors.lastname: Santasusana
authors.affiliation: Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco, Monaco, Monaco. eliane.gluckman@sls.aphp.fr.
authors.forename: Eliane
authors.initials: E
authors.lastname: Gluckman
authors.affiliation: EBMT Paris Office, Hospital Saint Antoine, Paris, France. Arnon.Nagler@sheba.health.gov.il.|Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel. Arnon.Nagler@sheba.health.gov.il.
authors.forename: Arnon
authors.initials: A
authors.lastname: Nagler
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001782:Blood Donors; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005060:Europe / Q000453:epidemiology; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007951:Leukemia, Myeloid / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D015996:Survival Rate; D055815:Young Adult