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Graft-versus-Host Disease after HLA-Matched Sibling Bone Marrow or Peripheral Blood Stem Cell Transplantation: Comparison of North American Caucasian and Japanese Populations.

Abstract
The risk of acute graft-versus-host disease (GVHD) after HLA-matched sibling bone marrow transplantation (BMT) is lower in Japanese than in Caucasian patients. However, race may have differential effect on GVHD dependent on the graft source. North American Caucasian and Japanese patients receiving their first allogeneic BMT or peripheral blood stem cell transplantation from an HLA-matched sibling for leukemia were eligible. BMT was performed in 13% of the Caucasian patients and in 53% of the Japanese patients. On multivariate analysis, the interaction term between race and graft source was not significant in any of the models, indicating that graft source does not affect the impact of race on outcomes. The risk of grade III or IV acute GVHD was significantly lower in the Japanese patients compared with the Caucasian patients (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.57 to 0.96), which resulted in lower risk of nonrelapse mortality in the Japanese patients (HR, 0.69; 95% CI, 0.54 to 0.89). The risk of relapse was also lower in this group. The lower risks of nonrelapse mortality and relapse resulted in lower overall mortality rates among the Japanese patients. In conclusion, our data indicate that irrespective of graft source, the risk of severe acute GVHD is lower in Japanese patients, resulting in a lower risk of nonrelapse mortality.
AuthorsJunya Kanda, Ruta Brazauskas, Zhen-Huan Hu, Yachiyo Kuwatsuka, Koji Nagafuji, Heiwa Kanamori, Yoshinobu Kanda, Koichi Miyamura, Makoto Murata, Takahiro Fukuda, Hisashi Sakamaki, Fumihiko Kimura, Sachiko Seo, Mahmoud Aljurf, Ayami Yoshimi, Giuseppe Milone, William A Wood, Celalettin Ustun, Shahrukh Hashimi, Marcelo Pasquini, Carmem Bonfim, Jignesh Dalal, Theresa Hahn, Yoshiko Atsuta, Wael Saber
JournalBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (Biol Blood Marrow Transplant) Vol. 22 Issue 4 Pg. 744-751 (Apr 2016) ISSN: 1523-6536 [Electronic] United States
PMID26762681 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)
CopyrightCopyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
Topics
  • Acute Disease
  • Adolescent
  • Adult
  • Asian People
  • Bone Marrow Transplantation
  • Chronic Disease
  • Female
  • Graft vs Host Disease (ethnology, mortality, pathology, therapy)
  • Histocompatibility Testing
  • Humans
  • Leukemia (ethnology, mortality, pathology, therapy)
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation
  • Recurrence
  • Risk
  • Severity of Illness Index
  • Siblings
  • Survival Analysis
  • Tissue Donors
  • Transplantation, Homologous
  • White People

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