Graft-versus-Host Disease after HLA-Matched Sibling Bone Marrow or Peripheral Blood Stem Cell Transplantation: Comparison of North American Caucasian and Japanese Populations.
Graft-versus-Host Disease after HLA-Matched Sibling Bone Marrow or Peripheral Blood Stem Cell Transplantation: Comparison of North American Caucasian and Japanese Populations.
复制标题
DOI：
10.1016/j.bbmt.2015.12.027
复制
发表时间：
2016-04
期刊：
影响因子：
--
通讯作者：
Saber W
中科院分区：
文献类型：
--
作者：
Kanda J;Brazauskas R;Hu ZH;Kuwatsuka Y;Nagafuji K;Kanamori H;Kanda Y;Miyamura K;Murata M;Fukuda T;Sakamaki H;Kimura F;Seo S;Aljurf M;Yoshimi A;Milone G;Wood WA;Ustun C;Hashimi S;Pasquini M;Bonfim C;Dalal J;Hahn T;Atsuta Y;Saber W
日本人HLA相合同胞骨髓移植后发生急性移植物抗宿主病（GVHD）的风险低于高加索人。然而，种族可能对GVHD有不同的影响，这取决于移植物来源。北美白人和日本患者首次接受来自HLA匹配同胞的异基因骨髓或外周血干细胞（PBSC）移植治疗白血病符合条件。分别有13%和53%的白人和日本患者使用BM。在多变量分析中，种族和移植物来源之间的相互作用项在任何模型中都不显著，表明移植物来源不影响种族对结局的影响。日本患者发生III-IV级急性GVHD的风险显著低于白人患者（风险比（HR）0.74，95%置信区间（CI）0.57-0.96），这导致日本患者的非复发死亡率风险较低（HR 0.69，95% CI 0.54-0.89）。这一组的复发风险也较低。非复发死亡率和复发风险较低导致日本患者的总体死亡率较低。总之，无论移植物来源如何，日本患者发生严重急性GVHD的风险较低，这导致非复发死亡率的风险较低。
The risk of acute graft-versus-host disease (GVHD) after HLA-matched sibling bone marrow (BM) transplantation 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 BM or peripheral blood stem cell (PBSC) transplantations from an HLA-matched sibling for leukemia were eligible. BM was used in 13% and 53% of Caucasian and Japanese patients, respectively. In 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 grades III–IV acute GVHD was significantly lower in Japanese than in Caucasian patients (hazard ratio (HR) 0.74, 95% confidence interval (CI) 0.57–0.96), which resulted in lower risk of non-relapse mortality in Japanese patients (HR 0.69, 95% CI 0.54–0.89). The risk of relapse was also lower in this group. Lower risk of non-relapse mortality and relapse resulted in lower overall mortality rates among Japanese patients. In conclusion, irrespective of graft source, the risk of severe acute GVHD is lower in Japanese patients, which results in lower risk of non-relapse mortality.