title: 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.
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.|b Department of Hematology & Oncology, Graduate School of Medicine , the University of Tokyo , Tokyo , Japan.|c Department of Hematology , Tokyo Women's Medical University , Tokyo , Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Shinohara
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inamoto
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Saiko
authors.initials: S
authors.lastname: Kurosawa
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Hiramoto
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ueda
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Tada
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Yujin
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Morikawa
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Okinaka
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Kinuko
authors.initials: K
authors.lastname: Tajima
authors.affiliation: a Department of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D002648:Child; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012008:Recurrence; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D014019:Tissue Donors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D006680:HLA Antigens
keywords: Gender-mismatched allogeneic hematopoietic stem cell transplantation; graft-versus-host disease; graft-versus-tumor effect; immune response